


Medicine

by Eighty_Sixed



Series: Scablands [3]
Category: Twin Peaks
Genre: Angst, Codependency, Depression, Emotional Hurt/Comfort, Gen, Mental Health Issues, Mental Institutions, Mythology References, POV Outsider, Permanent Injury, Post-Traumatic Stress Disorder - PTSD, Psychological Horror, Self-Harm, Suicidal Thoughts
Language: English
Status: Completed
Published: 2020-11-30
Updated: 2020-12-08
Packaged: 2021-03-09 18:26:41
Rating: General Audiences
Warnings: No Archive Warnings Apply
Chapters: 10
Words: 30,705
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/27790723
Author URL: https://archiveofourown.org/users/Eighty_Sixed/pseuds/Eighty_Sixed
Summary: There's something strange about the new patient at Eastern State Psychiatric Hospital.
Relationships: Dale Cooper & Harry Truman
Series: Scablands [3]
Series URL: https://archiveofourown.org/series/1985891
Comments: 2
Kudos: 9





	1. Chapter 1

**Author's Note:**

> This is the third and final fic in my Scablands series. It covers approximately the same events as the first two fics in the series, but this one is from an outsider POV (that of Dr. Sherman, the psychiatrist OC from the earlier fics). There's a fair amount of darkness and some mythology in this one. It won't make sense unless you've read the other fics in the series.

It was already late, but Alice was too restless to go to bed. She had driven out to the reservation today to see her Gran. Once again, she had tried to convince Gran to leave the res and move into town, and once again, Gran had refused. This was a ritual the two of them had performed on a near-weekly basis for over a year now, ever since Gran had had her stroke. As always, Alice had pointed out that the small clinic on the reservation was not equipped to provide comprehensive care if Gran had another stroke, and that it was foolish for someone with Gran’s risk factors to live an hour away from the nearest hospital. As always, Gran had steadfastly maintained that she wanted to spend her last days in what was left of her homeland, with her ancestors, where she belonged. The argument always went the same, but it always left Alice on edge. It was just one instance among many in which she felt the destabilizing effects of being pulled in two directions. On the one hand toward the reservation where she had grown up and where her family still lived and her people still practiced their traditions, and on the other toward the city where she lived now and the hospital where she worked and the medical science she had dedicated her life to. There had to be some sort of fulcrum that could balance her two worlds, but she hadn’t yet found it.

She really should get some sleep so she would be ready for her shift tomorrow, but first she needed a distraction to get her mind off Gran’s health. Distraction was a poor coping mechanism in the long run, as she well knew, but she also knew that sometimes you just had to get yourself through the night.

So she wandered into her living room and turned on the TV, flipping through the channels to try to find something mildly diverting to lull her to sleep. She clicked through infomercials, late-night talk shows, and old black-and-white movies. As she cycled through the channels, she came upon the start of the eleven o’clock news report. Normally, she would have kept going in search of something more relaxing, but what the anchorman was saying caught her interest. He had mentioned Twin Peaks.

Hearing the name of the town always gave her a strange feeling, like icy fingers trailing down her spine. Of course, the only time anyone ever mentioned the place nowadays was in the context of the serial killer who had been running amok there for the past few years, but her unease went deeper than that. Probably something from one of the stories Gran had told her when she was a little girl, but she couldn’t remember the details now.

The news story was, of course, about said serial killer. “Our top story tonight: the case of the infamous Twin Peaks Killer has come to a dramatic end,” the newsman announced. Alice put down the remote. She couldn’t help but pay attention to high-profile cases involving serial killers in the state, because there was always a decent chance that she would meet them. Any criminal defendants found guilty except for insanity ended up on a forensic ward at Medical Lake. She had treated a few psychopaths whom she had first become aware of through breathless TV coverage of their gruesome deeds. Now she leaned forward a bit, wondering if the Twin Peaks Killer would be showing up on her rotation before long.

The news cut to a reporter standing by the side of a small-town road. “I’m here in Twin Peaks, Washington, where the local sheriff’s department and the FBI have confirmed that, earlier this evening, a suspect in the Twin Peaks Killer case was involved in a shootout with local law enforcement and federal agents. The suspect received multiple gunshot wounds and was pronounced dead at the scene.”

Well, that was one psychopath Alice wouldn’t be meeting. She felt a guilty twinge of relief at that. She didn’t enjoy treating psychopaths, and it seemed that the Twin Peaks Killer had been an especially ruthless one. Intellectually, she knew that psychopaths weren’t to blame for their actions. They were sick, just like any of her other patients. But whereas she could easily feel empathy with her other patients, it took a conscious effort to feel compassion for psychopaths. They hurt other people, and they were incapable of empathy themselves. Even worse, there was no effective treatment for psychopathy, so all that could be done for them was to keep them locked away to prevent them from hurting anyone. Alice much preferred treating patients whom she could actually help.

The news report continued. “No law-enforcement officers were injured. Authorities have not yet confirmed the identity of the suspect. However, the prime suspect in the case has long been former FBI Special Agent Dale Cooper, the subject of a years-long manhunt in the wilderness of northeastern Washington State.”

Alice stared at the photo of the suspected killer displayed on the screen. The man was young and attractive, with a warm smile and kind eyes. But of course, psychopaths were often charming and likable. They knew how to manipulate people.

The reporter wrapped up the segment. “This small mountain community has gained national notoriety for being terrorized by the so-called Twin Peaks Killer, who is alleged to be responsible for thirteen brutal murders in the past five years. Now, with the death of the suspect, perhaps the town’s long nightmare has come to end.”

Alice rolled her eyes. She hated how the media sensationalized serial killers. That kind of coverage actively caused harm by feeding the egos and ambitions of any other potential would-be killers out there, and it was also just plain tacky. The news moved on to the latest updates in the case of the missing Edvard Munch painting, which had been stolen in Oslo a few weeks before, and Alice finally found herself getting sleepy.

Just as she was about to head upstairs to bed, she was startled back to full alertness by the sound of her pager going off. Surprised, she checked it. She was on call tonight, but it was rare that anything happened at the hospital that the night nurses couldn’t handle. They had pretty much seen it all. So a late-night call-in had to be something major. As she dialed the nurse’s desk, she tried to think of any red flags that might have indicated that one of her current roster of patients was about to have a major crisis. She came up blank. Erica, the lead nurse on the night shift, answered her call.

“I’m sorry about this, Dr. Sherman. I know it’s late.”

“That’s okay.” All traces of sleepiness were gone. Alice appreciated her job and the distraction it offered from her own problems by giving her the opportunity to help someone else with their much more serious ones. That was another of her coping mechanisms, another way to get through the night. “What have we got?”

“Incoming patient transfer.”

Alice was relieved that nothing had happened to any of the patients currently in her care. Her curiosity was also piqued. If they were bringing in a patient in the middle of the night, that person had to be in pretty bad shape. “From where?”

“Twin Peaks.”

Now Alice’s curiosity was really piqued. “Isn’t that where –”

“Where the cops just took out that serial killer, yeah.” Erica’s voice held an undercurrent of excitement that she was professional enough to mostly contain. “The local sheriff’s department says this patient was a victim of the killer. He was held captive for an indeterminate period of time.”

It immediately struck Alice as odd that the Twin Peaks Killer would keep one of his victims alive when he had very emphatically not done that with any of the others, but her job wasn’t to analyze the motives of the killer. Her job was to help the patient. So she asked, “What’s his condition?” She could hear papers rustling over the phone as Erica read through the report that had been called in.

“Deputies found him in the woods near the scene a short time after the shootout with the killer. He was found in a psychotic state, in the process of self-harm. He has self-inflicted lacerations to the face. After being restrained, he lapsed into catatonia. He’s been nonverbal and nonresponsive since.”

It sounded like a textbook case of a severe acute response to trauma. But Alice had learned not to make assumptions about patients before she had the chance to examine them herself. In the clinical setting, there was no such thing as a textbook case. Real people were so much more complicated.

“What’s the ETA?” she asked.

“About an hour.”

“Okay, get a team together. I’m on my way in.”

* * *

Alice and her team of nurses and assistants gathered at the hospital’s ambulance bay as the transport from Twin Peaks rolled in, right on time. As the patient was wheeled out of the ambulance on a gurney, one of the EMTs handed Alice the chart. The very first thing she saw when she glanced at it made her frown. “He’s a John Doe?”

The EMT nodded. “Maybe a drifter. He didn’t have any ID on him, and the locals at the sheriff’s department didn’t recognize him. Of course, they might not recognize him even if they do know him.” At Alice’s puzzled look, the EMT added, “You’ll see, the facial lacerations are pretty bad.”

Alice glanced at the gurney, which was now being maneuvered through the door by a couple of her assistants. The patient’s face was completely covered with bandages. Thanking the EMTs, she followed the gurney inside the hospital and then walked alongside as her team pushed it through the corridors.

“Sir?” she said, gently but insistently. She really wished she knew his name so she could call him by it. “Can you hear me?” Glancing at the chart, she saw that, based on the timing and dose of sedative the EMTs had given him, he should be awake. Sure enough, looking closely, she could see his open eyes through the narrow slit in the bandages. They were vacant and unfocused. Still catatonic, then, although the sedative was suppressing his level of responsiveness too.

“I’m Dr. Sherman,” she continued. She always spoke to nonresponsive patients in a normal tone of voice, in case they could understand her, to try to get them to engage. “I’ll be taking care of you.”

When they got to the exam room, Alice decided that the facial lacerations were the first priority. Blood was already starting to seep through the dressings that the EMTs had applied. Besides, as long as the sedative was in his system, she couldn’t get reliable information on his mental state. Better to take advantage of his sedated state to get the potentially painful work of cleaning and redressing the wounds out of the way. So she and Erica gingerly removed the bandages, a task made difficult by the dried blood gluing the dressings to the damaged skin.

As they pulled away the last scraps of bandage, they got their first look at the new patient’s face, and Erica hissed sympathetically. Alice understood now what the EMT had meant about the locals not being able to recognize the man even if he was from their town. The mess of blood and exposed tendons was barely recognizable as a human face, let alone being identifiable as a specific individual. Alice had come across a lot of self-harm in her career, but this was by far the worst non-lethal example she had ever seen. She knew that most patients who engage in self-harm use it as a coping mechanism to relieve feelings of anxiety or depression or emotional numbness. But this man looked as though he had had some other purpose in mind, as if he had been systematically trying to remove as much skin from his face as possible. Also, most patients cut themselves on the arm or leg, somewhere they could hide with clothing. Self-inflicted injuries to the face were unusual enough that she couldn’t help but immediately wonder what exactly had precipitated the patient’s actions. Of course, self-punishment was a motivating factor for some patients who engaged in self-harm. What this man had done certainly seemed consistent with self-punishment. But it was counterproductive at this point to speculate about what had caused the behavior. There was no way to determine that until she knew more about the patient and what he had been through, and there was no way to find out that information while he was catatonic and sedated. And in the meantime, she had to focus on treating the physical injuries.

Except, she realized as she took a closer look at the injuries, she wasn’t qualified to do that. As a psychiatrist, she wasn’t a specialist in physical trauma. She frequently treated minor wounds sustained by patients in the hospital, but these kinds of deep-tissue injuries were beyond the scope of her practice.

“Erica,” Alice said as she continued to examine the wounds, “please page whoever we have on call at Sacred Heart. Ask them to come here, I don’t want to have to transport the patient again tonight.” Erica nodded and left to go make the page. The state psychiatric hospital gave privileges to several emergency medicine physicians at one of the main hospitals in Spokane, so that they could treat any acute medical issues that the psych personnel weren’t equipped to deal with.

Peering at the lacerations, Alice could see they had been made by several different implements. In some places, there were deep gouges in the flesh, like something had bored through the skin. In other places, there were large areas of skin that were missing entirely, exposing the fascia beneath. All the wounds had ragged edges, and some were still seeping blood. Glancing at the patient’s hands, Alice saw blood under his fingernails. But he couldn’t have done all that damage with his bare hands. “Tony,” she said to one of the nurses, “does the chart say what used to make these cuts?”

Tony flipped through the chart. “A stick and a piece of obsidian.”

Use of those implements meant that the injuries were definitely high-risk for infection. Alice ordered the nurses to start an antibiotic drip and to administer a tetanus shot. It had been long enough since the EMTs had administered the sedative that it was safe to give enough dose, so she ordered that as well. Treating the wounds would be a painful process, and she didn’t want the patient to feel any of it.

While waiting for the on-call emergency physician to arrive, Alice and the nursing team started debriding the wounds with tweezers. The EMTs had done all they could in the field, but now every bit of debris had to come out so it wouldn’t lead to infection later. It was a slow process, and Alice and her team were still debriding when the ER doctor arrived.

“Dr. Sherman,” he said, nodding to her in greeting.

“Dr. Brown,” she acknowledged. She had worked with him a few times before.

“So these are self-inflicted?” he asked, walking over to take a look. He had the uneasy look that outside personnel often had within the confines of the psychiatric hospital.

Alice gave him the rundown of what little they knew about the patient and the nature of his injuries. Dr. Brown shook his head in disbelief. “Never a dull moment out here at Medical Lake. Well, I can suture the smaller lacerations. But some of these wounds can’t be closed. Those probably need skin grafts. I recommend calling in plastics for a consult. You’ll have to wait till morning though, those guys only work the day shift.”

“We’ll have to go to Sacred Heart anyway for a CT scan in the morning,” Alice said. “We can get a plastics consult while we’re there.”

“Yeah, probably for the best. Those hotshot surgeons wouldn’t set foot in this place. No offense.”

It took hours for Dr. Brown, assisted by Alice and her team, to debride, clean, suture, and dress the wounds. When they finished, Dr. Brown wished them luck and departed.

The sedative had worn off, but the patient hadn’t moved. He lay on the exam table, his eyes open but still unfocused. It was time to do a full physical exam. The nurses removed the patient’s clothing, and Alice thoroughly checked for any injuries that the EMTs might have missed. She was somewhat surprised to see the smooth youthful skin that had been hidden by his clothes. Based on what was left of his face, it had been impossible to tell the patient’s age, but now she realized that he must be young. There were two long-healed but still prominent scars on his abdomen, one right below the ribcage and one a bit lower. She thought the first looked like a stab wound and the second like a gunshot wound, but with her relative lack of experience with physical trauma, she couldn’t be sure. What was clear was that he had suffered serious, potentially life-threatening, injuries long before his more recent ordeal. Maybe the EMT was right and he was a drifter. That was consistent with her observation that the patient was underweight. On the other hand, the malnutrition could mean that his captivity had lasted for longer than she had initially assumed, maybe for weeks or even months.

“I bet there’s someone out there who’s worried about you,” Alice said softly to the patient. “If there is, I promise I’ll do my best to find them.”

With the physical exam complete, the nurses dressed the patient in a gown and sat him up. What Alice really needed to do now was a psychiatric exam, but nonresponsive patients were a challenge. Experimentally, she lifted the patient’s arm straight out to his side, then let go. The arm stayed right where it was. “Wavy flexibility,” Alice said to the nurses. That was a common psychomotor condition in catatonic patients.

Moving his arm back down, Alice stood just to the side of the patient said, “Sir?” several times in a firm tone of voice. The patient didn’t respond. So she moved in front of him and moved her finger across his field of vision. No eye movement. She repeated the exercise with a penlight. Still nothing. She tested for pain response with a sternal rub. Nothing.

“He’s really deep in there, isn’t he?” Erica asked. “Could it be neurological?”

“We’ll have to rule that out with the CT scan,” Alice said. She checked her watch. It was just after five in the morning now. “Call Sacred Heart and order a scan for after the day shift starts. Call in a consult with the plastic and reconstructive surgery department too. You’ll also need to arrange transport. Oh, and push all my morning sessions to the afternoon. I’ll ride over to Sacred Heart with him.” They always had a psych specialist accompany patients when they needed outside medical care, just in case. Alice could send a nurse, but all her other patients were stable for now, and she felt protective of this new patient.

Erica went off to make the calls, and Alice asked Tony to administer intravenous benzodiazepine to try to relieve the catatonic state. “Then get him settled in a room, but continue to monitor him. Page me if he shows signs of response to stimuli.”

Alice went to her office. There was no point in going home now, as her regular shift started in less than three hours, but a nap on the sofa would be enough to get her re-energized for the day. She set an alarm, fell asleep almost immediately, and woke up feeling reasonably refreshed. She walked through the corridors, where the day-shift staff were starting to stream in, to the new patient’s room.

“Anything?” she asked Tony as she entered. She assumed the patient was still unresponsive, otherwise Tony would have paged her.

“No, Doctor,” Tony answered. “No change.”

“Hmm,” Alice said thoughtfully. “Usually benzo does the trick.” She went through the litany of external stimuli tests again, still getting no response. “Well, we need to change his dressings again anyway,” she said. “Tony, would you mind helping me with that before you go home?”

“Sure thing.” As they started removing the old bandages, Lindsay, one of the day-shift nurses, stuck her head into the room.

“There you are, Dr. Sherman,” Lindsay said. “Nancy at the front desk is on the phone at the nurse’s station. Wants to talk to you.”

“Okay. Can you help Tony finish up here?”

While Lindsay and Tony continued changing the bandages on the patient’s face, Alice went to the nurse’s station and picked up the phone. “Hi, Nancy. You wanted to speak with me?”

“Doctor, I’ve got an uncredentialed visitor out here in the lobby. He’s a cop from Missoula, keeps waving his badge around like it means something. Seems pretty agitated. Anyway, normally I’d send him on his way, but he says he’s here to see the John Doe from Twin Peaks –”

“I’ll be right out.” She had had a feeling that there was someone out there looking for her new patient. She headed to the lobby, where a man was pacing around with frantic energy. Her first impression of him was that he was that of someone at the end of his rope, raging against the cruelty of an indifferent universe. She had seen that kind of look on a thousand patients. As he turned to face her, she could see that his eyes were bloodshot and rimmed by dark circles. She moved closer and caught a whiff of alcohol. He had the same look her father had had in the years he had spent drinking himself to death.

“Good morning, Officer …?” Alice said, projecting her most calming demeanor.

“Harry Truman.” 

Blinking at the name, Alice said, “I’m Dr. Sherman. I’m in charge of the care of our new patient from Twin Peaks.”

“Please let me see him.” Officer Truman sounded as he was begging for his very soul, and Alice hated to have to refuse him.

“Officer Truman, this is a secure facility. We have several forensic units. Many of our patients could be a danger to themselves or to others. So for the safety of our patients and our staff, we have to do a security screening of everyone who enters this hospital.” She hoped that, as a police officer, the security message would resonate with him.

“I understand. So screen me.” He sounded as if he expected someone to step out and frisk him and then wave him through. Alice reluctantly had to disappoint him once again.

“There’s a visitor application form.” She nodded to Nancy, who handed Officer Truman the paperwork. “Just fill it out, and you should hear back within five business days –”

“Five days? Why the hell does it take so long?”

“You need to go through a criminal background check –”

“I’m a police officer!” His voice was getting louder, and one of the security guards looked like he was about to make a move, but Alice waved the guard off. She was confident that Officer Truman wasn’t dangerous. It was classic transference. He was worried about the patient, whoever he was to him. That fruitless worry was manifesting itself as anger at the nearest convenient target, which happened to be Alice.

“Then maybe your screening will be expedited.” She hoped so, as it seemed a bit ridiculous to make a police officer go through a criminal background check. But she didn’t make the rules. “I’m not sure, that’s up to our security department,” she added. Something about the man gave her the sense that he could be reasoned with, so she continued in a low voice, “Officer Truman, I have to tell you, even if you were on our approved visitors list, I wouldn’t let you in now. Aside from the fact that it’s outside visiting hours, you’ve been drinking. And you’re upset. So please, just fill out the application, go home, and get some rest. You can come back once your application is approved.”

Officer Truman visibly weighed his options and, seeing how limited they were, got himself under control. “Okay. But will you at least tell me how he is?”

“What is your relationship to the patient?” She had to ask, for reasons of patient confidentiality, but she was pretty sure that they had to be family.

“He’s my – my cousin. His name is Dan Carter.” The hesitation was slight, but Alice observed human behavior for a living, so she immediately suspected that Office Truman was not being entirely truthful. At the same time, she also still believed that they were family, so she wasn’t quite sure what she thought Officer Truman was lying about. On the bright side, she now had a name to call her John Doe.

Wanting to provide some reassurance, but also not wanting to violate patient privacy, she kept it vague. “Well, Dan has been through a lot. Right now, he’s being treated for his injuries.” Officer Truman turned a bit pale at the mention of injuries. Had he not known about the facial lacerations? As a matter of fact, how _had_ he known where Dan was, when the Twin Peaks sheriff’s department had been unable to ascertain the victim’s identity? How did Officer Truman even know that the John Doe was his cousin? Not wanting to interrogate the man when he was clearly in distress, Alice continued, “Later today, I’ll do a full psychiatric evaluation. We’ll know more about his condition then. But in the meantime, please rest assured that your cousin is getting the best psychiatric care in the state.”

Officer Truman thanked her, a bit gruffly, but sincerely enough, and Alice went back to her patient. Tony had left after finishing the re-bandaging job, and Lindsay was now trying to get the patient to eat some oatmeal.

“Any luck with that?” Alice asked.

Lindsay shook her head. “He doesn’t seem to see me, or the food.”

Alice hoped that they would be able to get the patient to eat on his own in the next day or two. If not, they would have to resort to a feeding tube, which was stressful for patients and staff. She came up to the bed and stood on one side from it, across from where Lindsay was standing with her spoonful of oatmeal extended helplessly in front of the patient’s face. The patient gazed listlessly straight ahead at nothing in particular.

“Dan,” Alice said firmly. “Can you hear me?” She was grateful that she at least had a name to call him now, but he didn’t respond. “I just saw your cousin Harry,” Alice continued. At that, Dan turned his face toward her. His eyes were still unfocused, but it was a stronger response than any she had been able to elicit so far. Encouraged, Alice said, “Harry will be back to see you.” Normally, she wouldn’t promise something like to a patient, because she had no control over whether family members chose to visit or not. But based on his behavior, she was confident that Officer Truman would be back, come hell or high water.

“Try again,” Alice said to Lindsay. Lindsay made another attempt with the spoon, and this time Dan took a bite. After a moment, he took the spoon from her and started eating the oatmeal on his own.

“Maybe the benzo is starting to kick in,” Lindsay said.

Alice shrugged. “Possibly. It is a good sign that his survival instinct is still intact.” She thought that the mention of Harry had probably done more than the benzodiazepine had.

Alice headed back to the nurses’ station to check in on their appointments at Sacred Heart. The transport was leaving in half an hour, which was just enough time for Dan to finish his breakfast and get cleaned up by the nurses.

She sat in the back of the ambulance with Dan as they made their way to Sacred Heart. Dan tolerated the CT scan well, likely because he was unaware of where he was. Alice conferred with a neurologist on the scans, and they saw no signs of physical damage to the brain. That confirmed Alice’s assumption that Dan’s condition was induced by psychological trauma. It had all the hallmarks of a brief psychotic episode. That was good for his prognosis, because it was a condition that patients normally recovered from on their own. She would discontinue the benzodiazepine and just give Dan the space and time he needed to come back and engage with the world again.

After the CT scan, another doctor entered Dan’s exam room and introduced himself as Dr. Chandra, a plastic surgeon specializing in facial reconstruction. He removed the bandages from Dan’s face so he could examine the damage.

“How severe is this patient’s psychiatric condition?” Dr. Chandra asked as he investigated the injuries.

“Brief psychotic disorder,” Alice answered. “He’s currently catatonic and nonverbal, but I expect he’ll come out of it in the next few days to weeks.”

“Probably best to wait until then to do any procedures,” Dr. Chandra said. “If he weren’t a psych patient, I would recommend doing skin grafts immediately to minimize scarring. But based on the depth of these lacerations, there’s likely also muscle and nerve damage. I need a cooperative patient to assess the current range of motion. Also, these procedures are painful and require patient compliance over a long recovery period to avoid infection and further injury. For a psychiatric patient, especially one who has engaged in this level of self-harm, the risks of surgery right now outweigh the benefits.”

Alice nodded. “Is there a specific time he would need the surgery by?”

“After the initial formation of scar tissue, it doesn’t make a difference how much longer we wait, although insurance tends to balk when there’s a long gap between the injury and the surgery. So I would leave it up to you to determine when his psychiatric condition has improved sufficiently to tolerate the procedure.”

Alice thanked Dr. Chandra, and she and Dan were taken in the transport back to Medical Lake. When she returned to the hospital, she gave her team instructions to let Dan rest in his room but to do frequent checks on his level of responsiveness. Then she got to work catching up on the individual and group sessions she had postponed from the morning. That kept her busy until the late afternoon. Finally, she settled into her office to finish her charting before she could finally head home and get some sleep.

The phone rang. It was Nick from the security department. “Hey, Doc,” he said. “I’ve got some more information on the John Doe from Twin Peaks. For starters, he’s not a John Doe anymore. The Twin Peaks sheriff called to tell us that they found new evidence at the scene that identifies the patient as Dan Carter, a man who went missing five years ago.”

“Five _years_?” Alice was incredulous.

“Yeah, it sucks, huh? Apparently, he was presumed dead, so they weren’t looking for him. But now they think he was held by the Twin Peaks Killer all that time, the poor guy.”

Alice leaned back in her chair. Five years. No wonder Dan was exhibiting such a severe trauma response. Who knew what he had gone through over all that time? And Officer Truman, too. He had thought his cousin was dead, only to find out that he had been held captive by a serial killer for five years. That was why he had been so frantic and so determined to see his cousin. Alice felt another wave of guilt over having had to send him away that morning.

As if reading her thoughts, Nick said, “Also, we got confirmation from the Missoula Police Department that Harry Truman is an officer there, so we’re waiving the background check. The Twin Peaks sheriff vouched for him, too. Says Officer Truman is Dan Carter’s cousin. We approved his visitor credentials, effective tomorrow.”

Alice thanked Nick and hung up. She pushed her charting aside, as her mind wasn’t really on it now. Standing up, she went over to her bookshelf and selected a few fat reference books and stacks of medical journals. Bringing them to her desk, she sat and paged through their tables of contents and indexes, looking for case reports of prolonged confinement. She couldn’t find many cases of captivity for five years or longer. Disturbingly, most of the cases she did find were of children who had been locked up by abusive parents. For adults, the closest analogue she could find to Dan’s situation was prisoners who were held in solitary confinement for years. One study leapt out at her. It found that the rate of self-harm was seven times higher among prisoners in solitary than in the general population. In a reference text, she found a long list of psychiatric conditions that were triggered or exacerbated by prolonged solitary confinement, including anxiety, depression, anger, cognitive disturbances, perceptual distortions, obsessive thoughts, paranoia, and psychosis. Any or all of those conditions could end up being long-lasting as a result of permanent changes in brain function. If, as seemed likely, Dan had had only his captor for company while being confined for five years, it would be reasonable to expect him to exhibit many of the same effects as those experienced by prisoners in solitary, many of which could be long-lasting or even permanent. And then there were whatever additional traumas his captor had inflicted on him over that time. It was looking like maybe this wasn’t a simple case of brief psychotic disorder. Alice was still confident that Dan would come out of the catatonic state before too long, but now she was less certain that he would be able to fully recover. She had never treated a patient who had been through anything like this.

Sighing, she closed the reference book. That was the wrong attitude. Everyone had their own traumas, and they were all unique. And every response to trauma was as unique as the person experiencing it. So she would just have to treat the patient who was in front of her, in all his complexity and unique experiences. That was what she did every day, and this would be no different.


	2. Chapter 2

On the news that night, Alice saw a brief segment updating the status of the Twin Peaks Killer case. The FBI and local sheriff had confirmed that the suspect killed in the shootout was former Special Agent Dale Cooper, and that evidence recovered at the scene proved definitely that he was the Twin Peaks Killer. Case closed. Alice noted, with some curiosity, that the news report made no mention of the fact that there was a survivor who had been held captive by the killer for five years. Since the news would have been all over that if they had known about it, she could only assume that they didn’t know. The law-enforcement agencies must have kept it quiet to protect Dan Carter’s privacy. Alice was grateful for that, as media attention would be the last thing her patient needed.

So the next morning, when she arrived at the hospital, she sent out a strongly worded memo reminding all the staff in the unit of the importance of patient confidentiality. Some of the staff, especially the newer ones, tended to get a bit giddy with high-profile cases, and she could easily imagine someone mentioning to their spouse or friend or even a co-worker on another unit that they were treating a survivor of the Twin Peaks Killer. She would do everything she could to nip that kind of gossip in the bud.

Alice also left word at reception that, if Officer Truman came by that afternoon for visiting hours, she was to be notified. She wanted to prepare him for the condition his cousin was in before he saw him. After leaving reception, she went immediately to Dan’s room to do another round of responsiveness checks. She had hoped that his condition had improved overnight, but it hadn’t. The nurses told her that he was still eating on his own, though. At least they wouldn’t have to resort to a feeding tube.

After seeing her other patients in the morning, Alice spent the afternoon completing the civil commitment paperwork for Dan. She had just faxed it to the court when the phone rang. It was Nancy in reception. “He’s back.”

Alice didn’t have to ask who. She glanced at her watch. 3 pm exactly. Officer Truman hadn’t wasted any time. “I’ll be right out.”

Officer Truman was once again milling nervously around the reception area when she arrived. He looked a bit better today, but still had an undercurrent of frenetic energy.

“Officer Truman, I’m glad your application was approved,” Alice said, smiling at him.

“Yeah, me too. Uh, sorry about yesterday.”

“It’s all right. I know this must be a difficult time for you.” She gave him instructions on going through security, telling him she’d meet him on the other side.

Alice went back to her office, and after a few minutes a security guard brought Officer Truman to her door. “Come in, Officer Truman,” she said.

“You can call me Harry,” he said as he came in and sat down.

“All right. Harry, the staff is bringing your cousin to the visitation room now. But before you go in to see him, I want to tell you what we’ve learned so far about his condition and what you can expect. First, we’ve treated the lacerations on his face. When they’ve had a chance to heal, and when Dan is able to tolerate the procedure, we can refer him to a specialist for reconstructive surgery.” Harry looked horrified at the mention of surgery, so she asked, “Are you okay?”

“Yeah. Go on.” Harry was clearly steeling himself for more bad news.

“Well, other than the facial injuries, and some malnourishment, he’s otherwise physically healthy. As for his psychological condition, I’ve diagnosed him with something called brief psychotic disorder.”

“What is that?” Harry’s tone was wary.

“It’s a condition characterized by the sudden onset of some form of psychosis following a major traumatic event. In Dan’s case, the form of the psychosis is severe catatonia. That means that, right now, he is in a dissociative state, completely nonverbal and nonresponsive to external stimuli. I want you to be prepared for that. He will not be able to speak with you, or to respond to you in any way.”

Harry nodded. “Why is it called brief?”

“That’s the good news. The condition is not caused by any underlying physical ailment, or by preexisting mental illness. I take it he was psychologically healthy prior to this ordeal?”

“Yeah.” Harry seemed lost in memory. “Healthier than anyone I know.”

“Actually, maybe you can help fill in some gaps in his medical history.” She didn’t want to keep Harry too long, as she could sense his eagerness to visit his cousin, but maybe she could at least get an explanation for the old injuries. “Do you know anything about the old scars on his abdomen? One looks like a stab wound and the other maybe a gunshot wound?”

“Uh, yeah,” Harry said, a bit sheepishly. “Those are from when he was stabbed and shot.”

“He was stabbed _and_ shot?” What else had this poor guy been through?

“Separate incidents,” Harry said, as if that made it any better. “He also used to work in law enforcement.”

“Wow. Sounds like a dangerous job.” Alice shook her head. “Well, did he experience any psychological symptoms after either of those prior incidents? Depression, anxiety, flashbacks?”

“No. He was fine.”

Alice doubted that that could be the case, but Harry seemed to sincerely believe it. At any rate, she could be fairly confident that Dan at least hadn’t suffered any severe symptoms from his prior experiences of trauma, because Harry would probably have known about it, given how close the two of them apparently were. Maybe those earlier traumatic experiences had even helped Dan develop some coping mechanisms, which could be helpful in the long run. “That’s good,” she said thoughtfully. “It sounds like he’s a very resilient individual, which is good for his prognosis. Generally, in this kind of trauma response, the psychosis resolves itself, usually within about a week to a month.” Harry visibly sagged with relief, and Alice quickly added her caveats. She was concerned about the level of trauma Dan had suffered and its potential long-term effects, and she didn’t want to give Harry false hope. “That doesn’t mean he’ll be back to his old self right away after he recovers from the catatonic state. Given all that he’s been through, I expect he’ll also have some post-traumatic stress, which often presents with chronic depression and anxiety. We’ll know more about his long-term prognosis once he’s able to communicate again. One more thing I wanted to update you on. I’ve filed my psychiatric evaluation to the court, and I expect that in the next day or two the judge will sign off on the civil commitment request.”

“What does that mean?”

“We have two groups of patients in the hospital,” she said, launching into her well-rehearsed State Hospital 101 spiel. “In the forensic units, we have defendants in criminal cases who were found guilty except for insanity, as well as some pending cases who are undergoing evaluation. Then we have our civil commitments, who are individuals who require 24-hour psychiatric care because they have been deemed a danger to others or themselves. That’s the group Dan is in.”

“But – he’s not a danger –” Harry looked like he was on the verge of panic.

“To others, no. He hasn’t displayed any violent tendencies. The red flag here is the self-harm. I’m hoping it was an isolated incident, because so far he hasn’t tried to harm himself again while in our care, but patients experiencing post-traumatic psychosis often behave unpredictably. That’s why I want to keep him in the hospital for now, and the civil commitment is what allows us to do that.”

“Oh.” Now Harry just looked defeated, no doubt at the prospect that Dan might hurt himself again.

“Also,” Alice said, trying to keep the focus on practical matters, “I assume there has been a lapse in his health insurance coverage, due to the length of his captivity.” That was putting it as delicately as she could, because she didn’t want to point out that Dan had been presumed dead. “But he will be considered a ward of the state once the court order goes through, so his care will be covered.”

“Okay. Good.” Clearly, how Dan’s care was going to be paid for had been the last thing on Harry’s mind.

“Do you have any questions?”

Harry’s response was immediate. “Can I see him now?”

Alice smiled. Harry had been very patient through their entire meeting, when the whole time he had been thinking of nothing other than finally getting to see his cousin. “Yes. But just be aware that he’s in a vulnerable state right now. Please be careful not to make any loud sounds or sudden movements around him. Avoid physical contact too. And if you feel yourself becoming upset or agitated, it’s best to leave.” That was her standard list of instructions to visiting family members. The last thing an emotionally vulnerable patient needed was a visitor who brought them additional stress.

Alice summoned a security guard to escort Harry to the visitation room. She had every intention of checking in on him after a while to see how the visit was going. But a few minutes after Harry left her office, she was paged to the unit because one of her schizophrenic patients was experiencing an acute crisis, hallucinating and threatening staff. It turned out that the patient had been secretly skipping her antipsychotic meds. After resolving that crisis, Alice stopped by the visitation room on her way back to her office and peered in through the window. There was no sign of Harry or Dan, even though she had only been gone for half an hour. “Did that visitor leave already?” she asked the guard who had escorted Harry.

“Yup. Left after just a minute. He seemed pretty upset.”

Alice winced sympathetically. Maybe she hadn’t adequately prepared Harry for seeing his cousin like that. Then again, there probably wasn’t any way to prepare someone for that kind of thing. Well, now Harry would either come back again, or he wouldn’t. If she had to bet, her money would be on him coming back after he had had a chance to adjust to the shock of how severe Dan’s condition was. He seemed so concerned about his cousin, she didn’t think he would stop visiting. On the other hand, she had thought that about family members before, only to never see them set foot in the hospital again. She couldn’t judge them either way. When she was a teenager, she had spent as much time as possible outside of the house so she wouldn’t have to see her father passed out on the couch surrounded by empty whiskey bottles. She couldn’t reconcile that image of her father with the laughing man she remembered from her childhood, the one who would pick her up and swing her around every day when he came home from work. Those two versions of her father didn’t seem like the same person and, in many ways, they weren’t. It was that incongruity that had led to her ambition to become a psychiatrist, so she could understand how mental illness could transform a loved one into a stranger, and maybe how they could be transformed back. Of course, it was only when she was well into her training that it had become clear that medicine didn’t always have the answers to those questions.

* * *

Harry did come back, the very next day. Alice was on her way back to her office after checking in on the schizophrenic patient who had been in crisis the day before. Realizing that it was almost 3:30, she stopped by the visitation room and glanced through the window. She could see the back of Dan’s head as he sat on a couch, and Harry was perched on the coffee table in front of him. Even though Harry was facing her, Alice could tell that all he saw was Dan. Harry was leaning forward, talking animatedly, and he appeared to be holding both of Dan’s hands between his own. Then Dan lifted his hands, and Alice saw that he was holding a coffee cup that Harry was helping him drink from. As Dan took a sip, Harry smiled at him. This was the first time Alice had seen a smile on Harry’s face.

Going back to her office, she kept the door propped open so she could monitor the traffic going down the hall. After an hour or so, she saw Harry being led by a security guard toward the exit. “Harry,” she called after him. “Do you have a minute to talk?”

“Sure.”

“I’ll see him out afterwards,” she said to dismiss the guard.

As Harry took a seat, Alice said, “I’m glad to see you back here today. I heard you didn’t stay long yesterday.”

“Just following your instructions. I got upset.” Harry swallowed and looked down.

“That’s perfectly understandable,” Alice said reassuringly. “It’s a shock to see a loved one in that condition for the first time. But I take it your visit went better today?”

“Yeah. He loves coffee. As in, the biggest coffee addict I’ve ever seen. So I brought him some, and he drank it.” Harry was smiling again. He really had such a kind face.

“That’s good. Smell and taste and very powerful senses for evoking emotional responses. So keep bringing him coffee if that’s something he enjoys. It may help him connect to the external world more quickly.” She doubted that coffee would be enough on its own to bring him out of the catatonia when benzodiazepine had failed to do so, but the combination of coffee and Harry’s presence could only have a beneficial effect.

“I was afraid there was nothing left of him,” Harry said, as if he were confessing a terrible secret. “After yesterday, when he didn’t even know I was there.”

“Just because he isn’t able to respond to you right now, doesn’t mean he doesn’t know you’re there.”

“So he does know?” Harry asked hopefully. “He sees me and hears me?”

“I can’t say for sure, but based on my experience with other patients, I think it’s likely.” She hoped that Harry would keep coming back, because having a supportive family member made a world of difference. She had seen so many other patients suffer alone.

* * *

As it turned out, Alice needn’t have worried about whether Harry would keep showing up. He was the most reliable visitor she had ever seen. He arrived every day, at 3 pm exactly. Dan never had any other visitors, but Harry was like Old Faithful. Most days, Alice would spend a few minutes observing them through the window of the visitation room. Harry always brought Dan a cup of coffee and sat in his field of vision, talking to him while he drank it. He often held Dan’s hand. Alice hadn’t specifically instructed Harry how to interact with Dan during their visits, but he seemed to understand it instinctively. Talking to him like they were having a normal conversation, making eye contact, engaging all his senses – all of these were exactly what Alice would recommend for trying to reach a catatonic patient.

Despite Harry’s best efforts, and hers, Dan showed no signs of coming out of the catatonia. Alice wasn’t too worried, as it had only been a couple weeks. She was, however, impressed at the depth of Harry’s commitment. Didn’t he live in Missoula? He must have taken time off work to stay somewhere locally. She had patients with family members who lived right in town but didn’t come to visit for months or longer, while Harry had apparently dropped everything just so he could spend a couple hours a day with someone who wasn’t even capable of acknowledging his presence.

As she watched them through the window, Harry’s face took on that soft smile he seemed to reserve for when he was looking at Dan or thinking about him. Alice wondered, not for the first time, whether they were lovers. Maybe, during her first meeting with Harry when she had sensed that he was lying about something, that had been it. Maybe Harry had said they were related because he was afraid the hospital wouldn’t let him visit Dan otherwise. She was sympathetic to that concern, although she would have been able to pull some strings to get the security office to recognize the relationship, whatever it was. But the Twin Peaks sheriff had confirmed that they were related. So unless he was in on the deception, Harry and Dan really were cousins. In any case, it was clear that Harry’s whole world revolved around Dan.

Alice went back to her office and started tackling some paperwork. Immersed as she was in the task, she didn’t notice that Harry was standing outside her door until she looked upon hearing his knock. She smiled and invited him in. Normally she was the one flagging Harry down to ask him how it was going, so she was curious about whether there had been some major development today that he wanted to inform her of.

“Hey, doc.” He looked tired as he sat down. Alice wondered again what his living situation was.

“Hi, Harry. How was your visit today?”

“Good. He turned his head to look at me.” Harry sounded like he was trying to tamp down his excitement because he wasn’t sure how significant a development it was.

“He made eye contact?” Alice asked to clarify.

“No, not exactly,” Harry said, a bit deflated. “But I moved while I was talking, and he turned his head to follow me.”

Alice remembered that Dan had done that to her on her first day in the hospital, when she had said Harry’s name. Whatever awareness Dan had, it seemed to be focused on Harry. Just as Harry’s world revolved around Dan, it seemed the reverse was also true.

“That’s good progress,” she said encouragingly. “It shows he’s getting ready to engage with the outside world.”

But Harry’s enthusiasm had dissipated, and now he just looked tired again. “How long do you think it will be before he, you know …”

“I know you’re eager for him to move into the stage of verbal communication. And he will get there. But there’s no set timetable.” It was also a tricky balance, trying to manage family’s expectations without being discouraging.

“Is there anything we can do to sort of speed things up?”

“Everything you’re already doing is helping immensely. I wish all my patients had a family member like you. I’ve seen how much support from loved ones can make a difference.”

What she said was the truth, but she could tell it wasn’t what Harry wanted to hear. He wanted a magic cure that could make his cousin immediately healthy again. But he just nodded and thanked her politely before leaving. Alice liked that about Harry. People often challenged her expertise because of her age and gender, with family members of patients sometimes even asking if they could get confirmation from a more “experienced” doctor. But Harry was always respectful to her, never questioning that she knew what she was doing. And she did feel confident that she was taking the right course with Dan by not being overly aggressive with pharmaceutical interventions to try to resolve the catatonia. She had never seen a patient who had experienced exactly what Dan had, but she had seen plenty of cases of brief psychotic disorder. It always resolved itself, albeit often with long-term complications from the initial trauma. Allowing Dan to gradually emerge from the protective mental state he had created for himself on his own time would put him in a better position to deal with whatever chronic conditions he would be facing.

A few days later, Alice stopped by Dan’s room during her morning rounds, where Lindsay the nurse was in the middle of the twice-daily changing of the facial dressings. Alice stopped her before she started rebandaging so that she could check the wounds. There were no signs of infection, and thick scar tissue had started to come in. All the gaping wounds were now closed. “We can leave the lacerations undressed now,” Alice told Lindsay, checking the chart to confirm the instructions that the surgeon had left. That would spare the nurses the time-consuming task of constantly rebandaging. Alice also hoped that maybe leaving Dan’s face uncovered would improve his peripheral vision and possibly contribute to greater awareness of his surroundings.

“Sure thing, Doc,” Lindsay said, packing up her dressing kit with a hint of relief.

Alice went through her usual checks of Dan’s level of responsiveness, finding no change. As she looked at Dan, an important thought suddenly struck her. “Lindsay,” she said, “please call the front desk and tell them I need to be notified when Harry Truman comes in today for visiting hours. Tell them not to let him through security until I’ve had a chance to prepare him for this.”

Lindsay looked at Dan’s disfigured face and nodded sympathetically. “Got it.”

All day long, Alice had running in the background of her mind what she would say to Harry about Dan’s scars. No doubt seeing the extent of his cousin’s injuries for the first time would be shocking no matter what, but Alice wanted to soften the blow by making sure he was adequately prepared.

Of course, the best-laid plans were often foiled by the unpredictability of life in a psychiatric hospital. In mid-afternoon, Alice got an urgent page about two patients in the rec room getting into a fistfight. When she arrived at the scene, half the on-duty staff were already there trying to defuse the situation. Apparently, each of the two patients believed that he was Jesus and took exception to the other’s claim that _he_ was Jesus. After much cajoling, both patients finally calmed down enough to be administered sedatives and taken to their rooms.

Breathing a sigh of relief that no one had gotten hurt, Alice glanced at her watch. It was 3:05 pm. Grabbing her pager, she saw that it hadn’t gone off. Hurrying through the halls toward the visitation room, she hoped that Harry had arrived a few minutes late for once, or maybe that reception had detained him but then neglected to page her.

No such luck. As she approached the visitation room, she could see through the window that Harry was standing inside, horrified and grief-stricken, as he stared at Dan’s scarred face. “Harry, I’m sorry,” Alice said as she burst inside. “We took the bandages off this morning. I asked the guards not to let you in until I had a chance to warn you, but I guess someone didn’t get the memo, and I was dealing with an emergency on one of the units—” She was furious at whoever had screwed up, but realized that most of the security guards had been dispatched to the scene of the fight, so it was understandable that this less-urgent task had fallen through the cracks.

“It’s okay,” Harry said in a sort of hollow voice, not even looking at her. He seemed unable to take his eyes away from Dan’s scars. “Why would he do that to himself?”

Alice wasn’t sure that she could answer that at all, but she definitely couldn’t try to explain it while her patient was potentially overhearing the conversation. “We shouldn’t discuss this in front of him. Why don’t you come to my office and we can talk there?”

“Can I visit with him first?”

Alice’s heart went out to Harry. Shaken though he was, he still wanted to go through with his normal visit. He probably needed the time and contact with Dan as much as Dan needed him. “Of course. Just stop by my office when you’re done. I’ll wait there for you.”

She went back to her office and finished her paperwork for the day, then waited around for Harry to show up. “Harry, I’d like to apologize again,” Alice said as soon as he appeared at her door. “I failed in my responsibility to prepare you for that.”

“Don’t worry about it, Doc,” Harry said as he sat down, subdued. “Nothing could have prepared me for that. “I just can’t believe he did that to himself.”

“Psychosis can lead to some pretty extreme behavior,” Alice said, wincing internally at the inadequacy of her explanation. “Disfiguring injuries are themselves traumatic, so once he’s able to communicate verbally again, this is something we’ll have to address.”

“You said something about plastic surgery?” Harry’s tone was flat.

“Yes, facial reconstruction really has come a long way. It will certainly be something to consider once he’s in a better mental state.”

Harry just nodded, clearly not interested in hearing more details about the surgery right now. “Anything else?”

“I just wanted to say that you handled that really well,” Alice said sincerely. “It must have been quite a shock to see him like that, but you were able to remain calm and stay with him. That’s the kind of support he’s going to need to get through this.” It boded well for Dan’s long-term recovery that he had someone as level-headed as Harry in his life. Alice wondered if Harry was that way because he was a police officer, or maybe it was just his personality. Either way, Harry seemed to be rock-solid in a crisis. Much as she hated to admit it, there were likely to be many more of those in Dan’s future.

* * *

Over a week later, Dan’s level of responsiveness remained unchanged. Late in the afternoon, when visiting hours were ending and Alice was packing up her things to go home, she saw Harry being escorted back to the exit. He had such a defeated slump to his shoulders that Alice was worried that something had happened. She stuck her head out of the door of her office, telling the guard she would walk Harry out. The guard nodded and left, but Harry just stood there in the hall, looking lost.

“Come sit down for a minute,” Alice told him gently.

Harry obediently took his usual seat across from her desk. “He squeezed my hand today,” he said.

Alice blinked in surprise. “You mean he did that spontaneously?”

Harry shrugged. “I always squeeze his hand when I arrive and right before I leave. Today he squeezed back.”

“That’s wonderful, Harry.” She was a bit confused about why he seemed so down when there had just been another breakthrough. “It means he’s communicating with you.”

“I know. I just –” Harry shook his head. “After that, I tried to get him to look at me or, you know, do _something_. But he didn’t.”

So Harry was disappointed that it hadn’t been more. “This kind of recovery proceeds in stages,” Alice said. “One step at a time.”

“Yeah, I know. I just _miss_ him.” Harry rubbed the back of his neck, looking completely exhausted. “I mean, I’ve been missing him for five years, you’d think I’d be used to it by now. But now …”

“Now it’s more difficult, because he’s here but not really,” Alice finished.

“Yeah.” Harry sounded miserable.

Alice leaned back in her chair. Harry wasn’t her patient, but he seemed so despondent that she wanted to try to help. “Tell me about Dan.”

“What do you mean?” Harry’s voice held a note of suspicion.

“I haven’t had the chance to really meet him yet, so tell him about him.” Maybe talking about Dan, about the way he used to be and hopefully would be again, would help lift Harry’s spirits.

Harry paused, then said, “Well, for starters, he’s brilliant. The way his mind works – I’ve never seen anything like it. He’s interested in everything. And he gets really excited about little things, things that most people take for granted. Like _trees_ and stuff like that. He just gets this big goofy grin, and you can’t help but be happy too.” Alice noted appreciatively that Harry was getting more animated as he spoke, and also that he was using the present tense to describe Dan. “And he’s so _good_. He always does the right thing, always.” Harry’s voice took on an anguished tone as he continued, “He didn’t deserve this. I mean, no one deserves to go through what he did. But the fact that it was _him_ , of all people –” Harry’s voice broke. “It’s just not fair.” Harry took a deep breath as he pulled himself together. “Anyway, you’ll like him, Doc. Everyone does.”

“I’m sure I will,” Alice said softly. She wasn’t sure that she had succeeded in lifting Harry’s spirits, exactly, but at least he seemed more confident now that she would be meeting her patient eventually.


	3. Chapter 3

A week later, as Alice sat in her office finishing her charting for the day, she heard a tentative knock on the door. She looked up and saw that it was Harry, looking anxious. She gestured for him to come in and sit. “How was your visit today, Harry?”

“Okay, I guess.” Harry looked as if he very much wanted to say something else, then apparently decided to just come out and say it. “It’s been a month.”

Alice nodded. She was aware of that. Privately, she was getting a bit concerned that Dan had been nonverbal for this long. She had never seen a case of brief psychotic disorder persist for this length of time. But, of course, every patient was different, and she was still confident in her initial diagnosis, so there was no need to make Harry more worried than he already was. So she just said, “Yes, it has. Now, you know there’s no set timetable for recovery from brief psychotic disorder. The average time is between a week and a month, but there is no strict upper limit for how long it can take. Dan is making good progress in gradually becoming more responsive, and I’m confident that that progress will continue.”

“I just want him to come back,” Harry said in a sort of hollow tone.

“He will.” Alice knew it was a bad idea to reassure patients’ family members like that, when there was never any guaranteed outcome. But she refused to believe that Dan would remain in a catatonic state forever, and she felt sure that it was important that Harry not believe that either, for his own sake and for her patient’s. “Don’t give up on him.”

“I won’t.” Harry spoke sharply, as if something in her words had struck too close to home.

“Of course. I’m sorry.” Alice felt for Harry, she really did. She didn’t often get to know family members this well, because so few of them came to visit on a regular basis. In fact, she was in the unusual position that she had spent far more time counseling Harry, the visitor, than she had Dan, her actual patient. It felt like they were both her patients, in a way. But there was little she could do to help Harry, other than to help Dan get better.

* * *

The next day, Harry didn’t come in for visiting hours. Alice only realized this when she walked by the visitation room around 3:30 and saw that Dan wasn’t inside. Frowning, she turned to the security guard who was monitoring the other patients and their families in the visitation room. “Did Harry Truman leave already?” Harry normally stayed for at least an hour, so if he had left that quickly, maybe something was wrong.

The guard shook his head. “Didn’t show at all today. I thought it was weird, that guy usually comes like clockwork.”

Maybe something was even more wrong than Alice had initially thought. “Page me if he does show up,” she told the guard.

For the rest of the afternoon, Alice couldn’t get her mind off Harry’s sudden absence. She kept thinking of their conversation the day before, when she had told Harry not to give up on Dan and he had responded so defensively that he wouldn’t. Would he really go back on his word just a day later? She understood that it must be difficult for Harry to keep coming back every day, but he had been doing it so religiously that it seemed impossible to imagine that he would just skip a visit without at least notifying her in advance.

Visiting hours ended, and Harry still had failed to materialize. Before heading home, Alice stopped by Dan’s room to do her usual twice-daily checks of his level of responsiveness. There was something different about him, nothing specific or quantifiable enough to put in his chart, just a sense she got that he was even more listless than usual. Alice felt a surge of anger at Harry on Dan’s behalf. Suddenly stopping visits was worse than never visiting at all. It was hard to believe that Harry would be cruel enough to build up Dan’s expectations that he would come every day, only to abruptly quit. Alice wanted to say something to Dan, that Harry would be back tomorrow, but she couldn’t risk giving him false hope in case he was disappointed again. She had to do what she did with any other patient and not make promises about family members’ involvement, because she apparently couldn’t trust Harry to be rock-solid in his reliability anymore.

On the drive home, Alice took several deep breaths. She realized she was projecting her own disappointment with Harry onto Dan. For all she knew, Dan wasn’t even aware that Harry had been visiting. That was the problem with nonverbal patients; it was all too easy to read into things that weren’t really there. Normally, she wouldn’t make such a rookie mistake, but there was something about those two that had her personally invested in a happy ending. Maybe it was the fact that, by all indications, Dan had been a happy and well-adjusted individual prior to the horrible experience he’d gone through, or maybe it was that Harry had been so devoted to his recovery, but she had been sure that this was one of those cases that was going to work out. Even through all those weeks of waiting with little improvement, she had been confident that it was just a matter of time. Now, Harry missing a single visit was enough to make her doubt herself and the good outcome she had envisioned. There were no sure things in psychiatric medicine, she knew that. She had just needed the reminder.

* * *

The next morning, Lindsay the nurse paged Alice to Dan’s room as soon as she arrived at the hospital. Alice hurried to the room, with a sinking feeling that something was wrong. The feeling was confirmed as soon as she entered. Dan was lying in his bed, staring sightlessly into the middle distance as always, but there was something subtly different about him.

Lindsay gestured helplessly at the breakfast tray she had brought in. “He won’t eat. I can’t even get him to sit up.”

“He’s resisting?” That was new. All this time, Dan had maintained a state of wavy flexibility, allowing himself to be posed and led around. If he was becoming less passive, that could be a good sign. Alice tried raising Dan’s arm, but he pulled back against the motion. No more wavy flexibility, then. She went through the rest of her checks, disappointed that he showed no improved response in any of the other metrics. No response to voice, light, motion. In fact, if anything, she felt that he was now buried even deeper. Before, she had felt a vague sense at times that he was reaching out and trying to listen, trying to see. Now, there was absolutely nothing. It was as if he had given up. Inwardly chastising herself for once again projecting a mental state onto her patient without data to support it, she noted the new resistance in the chart, leaving all other indicators as no change. Thinking for a moment, she ordered Lindsay to try administering benzodiazepine again. It hadn’t worked before, but it was worth another shot.

Leaving the room, Alice stopped by the nurses’ station to call reception and ask them to page her if Harry Truman showed up for visiting hours today. It looked like Dan wasn’t leaving his room today, and she would need to update Harry on Dan’s condition. Maybe she would also take the opportunity to sternly remind him of the importance of consistency in patients’ routines, and to recommend that he not skip visits without advance notice.

Throughout the day, Alice returned to Dan’s room to do responsiveness checks. He continued to resist being moved, but otherwise showed no sign of responsiveness. It looked like the benzo had failed again.

At exactly 3 pm, Alice got the call that Harry was in reception. “On my way,” she said. Whatever had happened the day before, it looked like Harry was back to his regular punctual schedule.

She stopped by Dan’s room on her way to the lobby. “Dan,” she said, placing her hand on his shoulder. “Harry is here to see you.”

Dan didn’t move. Usually, when she said Harry’s name, Dan moved his head or reacted in some way. It was pretty much the only thing that reliably got a reaction of any kind out of him. But now, there was nothing.

“Dan,” Alice said again, a bit more insistently. She leaned down into his line of vision. “If you want to see Harry today, you have to come with me. Do you understand?”

Still nothing. Alice tentatively tried to maneuver Dan into a sitting position, but he resisted. Alice sighed. For a nonverbal patient, that counted as a refusal. Now she was going to have to go out and explain to Harry why he couldn’t visit his cousin today.

The moment she saw Harry in the lobby, all the anger she had been feeling toward him dissipated. Harry looked like hell, exhausted and guilt-ridden, with a fresh black eye, clutching the coffee cup he always brought for Dan. Alice could see the sequence of events playing out: Harry had been despondent because Dan’s condition wasn’t improving. She already knew, based on their first meeting, that Harry used alcohol as a coping mechanism. So he had gone on a bender and, by the looks of it, gotten into a fight. She should have known that the only reason Harry hadn’t come the day before was because he couldn’t. She felt the same compassion toward him she had felt toward her father on those days when he was so sick and drunk he couldn’t even leave his bed. Harry had clearly punished himself enough for not showing up for his cousin, so there was no need for her to pile on with more judgment.

“Harry, what happened?” she asked, leaving him an opening in case he wanted to talk about it.

He didn’t. “Nothing major,” he said dismissively. “What’s going on? Is he okay?”

“He’s not hurt or anything,” Alice hedged. Seeing the panic-struck look on Harry’s face, she quickly added, “He’s had a little setback in his condition.”

“What do you mean?”

“He’s refusing to leave his room. He’s been there all day.”

Harry looked confused. “Well, maybe when I go in to see him, I can –”

“Harry,” Alice broke in. She hated this. It was such a rare thing to find a family member who was willing to enter a psychiatric hospital every day to watch someone they cared about struggle with mental illness. Harry would obviously walk through fire for his cousin, but now she had to turn him away. “You can’t go in to see him today.”

“Why not?” Harry still sounded confused, but now with a tinge of horror.

“Because patients have the right to refuse visitors at any time.”

“He’s not refusing me.” Harry’s tone was heartbreaking. “How would you even know? He can’t talk.”

“We can’t use physical force on patients unless absolutely necessary for their safety or that of others. Before, he was willing to be led into the visitation room, which we interpret as implied consent to receive visitors. Now, since he’s showing resistance to leaving his room, we have to respect his wishes.” Alice realized how ridiculous that probably sounded to a civilian, but it was important to respect patients’ rights.

“Well, let me see him in his room then,” Harry begged.

“I can’t. Visitors aren’t allowed on the units.” Harry looked so dejected that Alice felt she had to add something reassuring. “It’s counterintuitive, but this may actually be a good sign. Catatonic patients are typically very passive. This could mean he’s beginning to reassert his autonomy.” She winced at how unconvincing she sounded, even to herself.

Harry was clearly struggling not to lose his temper. “He probably thinks I abandoned him, because I didn’t make it yesterday. I tried, but something came up. So I need to see him so he knows I’m back now.”

Alice thought Harry was probably right about that. But there was nothing she could do. If Dan wouldn’t come to the visitation room, there was no way Harry could see him. So she said gently, “Not today, Harry. I’m sorry. You look like you’ve had a bit of a rough time anyway. Just go home, get some rest, and come back tomorrow.”

Harry abruptly turned and left. Alice watched him go, feeling guilty and unsure of herself.


	4. Chapter 4

Alice had learned long ago not to take her work home with her. She always thought of her drive home as a decompression, in which she turned on the radio and caught up on the news or sang along to pop music for the ten minutes it took to drive from the hospital to her house. By the time she pulled into her driveway, she was no longer Dr. Sherman, she was Alice, and thoughts of work and patients retreated to a distant corner of her mind. That sort of compartmentalization was essential for keeping the grimmer parts of her job from taking over her life. It was essential for her own mental health, and therefore for her effectiveness as a psychiatrist, and therefore for her patients’ mental health. The best way for her to care for them was to not obsess over them while not at the hospital.

Sometimes, though, those barriers broke down. Today was one of those days. She drove home on autopilot, the radio on but unheard. She found herself pulling into her driveway, but she had definitely not completed the decompression process. All she could think of was Dan’s empty gaze and Harry’s anguished pleading. These were always the times when the barriers broke, on those rare occasions when she doubted her own judgment on a case.

She went through the motions of cooking dinner, watching TV, reading, but nothing could distract her. She had been so sure that Dan’s diagnosis was brief psychotic disorder and that it would resolve itself, just like every other case of the disorder she had ever come across had resolved itself. But she was starting to question that. It was almost as if Dan was not just a prisoner in his own mind but was a prisoner of some external malevolent force. The name _Twin Peaks_ wafted into her mind, as if someone had whispered it from across the room. Feeling the chill always invoked by the town’s name, she shivered, wrapped herself in a throw blanket, and turned the TV up louder.

She spent the night tossing and turning in bed. Every time she closed her eyes, she felt an unsettled sensation in the air, like wings flapping or curtains rustling. But when she opened her eyes, she saw nothing but the familiar shapes of her room, gleaming dimly in the moonlight. Finally, just a couple hours before dawn, she fell asleep and slept hard and dreamlessly. Even though her alarm went off far too soon, she got out of bed feeling surprisingly refreshed and, even more surprising, resolved. Her sleeping mind had worked out the problem that her waking mind couldn’t, and now she knew what she had to do.

Upon arriving at the hospital, she stopped at reception and instructed them to page her again when Harry arrived in the afternoon. Then she went straight to Dan’s room. Lindsay was there, once again looking frustrated as she tried and failed to get Dan to eat breakfast.

“Still refusing food?” Alice asked.

“Refusing everything. Doctor, it’s been over a day since he’s eaten anything. What should we do?”

“We have time,” Alice said calmly. There was certainly no need for drastic action like feeding tubes, not yet anyway. She went through the responsiveness checks, finding nothing, then turned to Lindsay. “I need you to discreetly tell everyone who will be working the floor this afternoon that I’m bringing Harry to Dan’s room for a quick visit, if Dan refuses to go to the visitation room.”

“But … visitors aren’t allowed in patient rooms,” Lindsay said slowly.

“Yes, I know. That’s why I’m asking you to be discreet about it. If anything goes wrong, I’ll take full responsibility. Got it?”

Lindsay nodded, her eyes wide. “Sure thing, Doc. Harry’s a good guy, I know everyone will cover for him.”

At 3 pm, Alice got the page telling her that Harry had arrived. On her way to reception, she stopped by Dan’s room to make one more attempt to get him to leave. He had at least shifted position, now sitting up in the bed with his back against the wall. Alice sat down next to him. “Dan,” she said. “Harry is here. I know he wants very badly to see you today. And I think you want to see him. But you have to come with me, so I can take you to him.” She gently tugged on his arm, but he refused to move. The look in his eyes was deeply unsettling. Not only did it seem that he couldn’t see her or hear her, it was like there was nothing left of him to see or hear with.

Resigned to Plan B, Alice headed to reception. Her earlier resolve, her conviction that had arisen overnight that Harry could somehow reach Dan when nothing else could, had started to weaken. Maybe it was because she was nervous about her imminent breach of hospital policy, or maybe it was because of that dead look in Dan’s eyes. Either way, she now felt uneasy, questioning yet again whether she was doing the right thing.

In the lobby, she didn’t even wait for Harry to ask the question he was obviously about to ask. “He’s still refusing to leave his room,” she said without preamble. “And he hasn’t eaten anything all day today or yesterday. If that keeps up, we’re going to have to take drastic action that I would like to avoid.” Harry looked terrified, and Alice regretted being so blunt about it. She was just eager to implement this possibly ill-conceived plan of hers so it would all be over with, one way or another.

“Doc,” Harry said desperately, “you have to let me see him.”

“I am,” she said, stepping closer and glancing over her shoulder to see if there were any wayward administrators hanging around. “Listen, I’m going to take you to his room. You can’t stay long, just five minutes or so. Needless to say, this is a rule violation. I’ve told the on-duty nurses and security staff what’s going on, but if an administrator happens to come onto the floor and sees you, there will be hell to pay.” She didn’t add _please don’t get me fired_ , but Harry got the message anyway.

“If that happens,” he said gallantly, “I’ll say I snuck in, that I stole your security badge or something.”

“Thanks. Don’t worry, it probably won’t happen. Administrators hate coming into the units.” That was true. She could count on one hand the number of times she had seen one of the suits on the floor. Despite being in charge of a psychiatric hospital, the higher-ups seemed to be uncomfortable around actual psychiatric patients.

Alice brought Harry with her through the staff entrance and then ushered him through the halls as quickly as possible. When they arrived at the door to Dan’s room, Alice turned to Harry. “I’ll come get you in five minutes,” she said, then left to give them some privacy.

Alice did a couple of anxious loops of the floor, keeping an eye on her watch the whole time. When five minutes had elapsed, she returned to Dan’s room. Sticking her head in the door, she was shocked by what she saw. Harry, his face streaked with tears, was embracing Dan as if he would never be able to let him go. Dan was facing away from her, but she could see that his arms were around Harry too. He was returning the hug. She felt herself break out in a smile. It looked like her instincts had been right. Harry had been able to reach Dan after all. The way the two of them were clinging to each other, she couldn’t bring herself to tear Harry away just yet. So she signaled to him that she would give them five minutes, and Harry nodded in acknowledgement.

Alice circled the floor a few more times, this time with a spring in her step. She knew it would likely be a long road to recovery for Dan, but getting him out of the catatonic state was a major breakthrough. After the allotted five minutes were up, she returned to the room, a bit nervous that she had pushed Harry’s time on the unit too far and risked getting found out. Harry, seeming to understand, got up. He told Dan, “I have to go now. I’ll be back tomorrow. But you have to let them take you to the visitation room. And you need to eat, okay?” Alice was satisfied to see Dan nod. He really was responsive now. More than that, his eyes were fixed on Harry, as if the world had just snapped back into focus. Harry handed Dan the coffee he had brought, and then followed Alice out of the room.

Alice didn’t dare to say anything to Harry until they were safely back in reception. Then she turned to him with a grin, saying, “Well, that looked like some major progress in there.”

Harry smiled back. “He said my name. Twice. And he looked right at me.”

“That is wonderful, Harry. I only observed a bit of your interaction, but I saw from the way his eyes tracked and how he responded to your words that he’s no longer in catatonia.” Harry seemed so deliriously happy that Alice felt the need to tone down expectations for the next stage. “But remember,” she said, “this doesn’t mean that he’s suddenly all better. There will likely be a period of adjustment when he still has minimal verbal expression. It’s important to let him go through that transition at his own pace. Eventually, he will likely have questions about what’s happened, especially since the ordeal he went through occurred over such a long expanse of time. You should answer his questions honestly, but wait until he asks. Don’t overwhelm him with too much information at once. Even though he’s no longer paralyzed by his trauma, he still has a lot of healing to do.”

“Got it,” Harry said seriously, and then showered her with thanks for sneaking him in. Alice almost couldn’t believe that she had violated the rules so flagrantly, but it had been worth it after all. She had been right to trust her instincts.

After Harry left, Alice sent a nurse to bring Dan a meal. She went to his room a while later, pleased to see that he had eaten most of the food, as per his promise to Harry. “Dan,” she said, “I’m Dr. Sherman. I don’t know if you remember, but I’ve been overseeing your care.”

Dan didn’t say anything, but he nodded. Whether he was indicating that he did remember or just acknowledging that he understood her, Alice couldn’t tell, but it didn’t really matter. He was making eye contact and responding to her words, so she had some positive results to record in the chart.

“I just want you to know that I’m here to help, and so are the rest of the staff,” she went on. “If you need anything, just let us know. Tomorrow morning, I’d like to spend some time with you. You don’t have to talk if you’re not ready, but I’ll listen to anything you want to say. And Harry will be back to visit you again tomorrow afternoon, okay?”

Dan nodded again, with more enthusiasm this time. Alice bid him good night and then left the hospital to head home. This time, on the drive, she turned up the radio and sang along the whole way.


	5. Chapter 5

As Alice had suspected, Dan was not in a talkative mood when he was brought to her office the following morning. She saw him looking at the basket on her desk, so she handed it to him and told him how it was made, from reeds twisted and braided together. She explained how her people had made baskets with that same design for countless generations, and that the women would take the baskets into the mountain meadows in late summer to fill them with huckleberries. She told him that her grandmother had taught her how to weave baskets, and that the one on her desk was the first one she had made as a teenager. That was why it was a bit crooked, she said with a smile. She talked about her grandmother, and about the reservation where she had grown up, where the fir-mantled mountains stood like guardians above the river. She talked, and Dan listened. She could tell he was listening because he watched her as she moved around the room, sometimes tilting his head while he examined her handiwork on the basket. This was why she kept personal objects in her office. Trust was a two-way street, and she couldn’t expect patients to open up to her unless she was open herself.

Finally, Alice asked Dan a question. “Would you like to tell me how you’re doing?” Dan just shook his head. “That’s okay,” Alice reassured him. She hadn’t really been expecting him to talk today. It took time to establish a rapport with any patient, and in Dan’s case he hadn’t spoken in so long that it must be a challenge just to find the words.

During the next few days, Harry came to visit at his regular schedule. Alice tried to find activities for them to do together. Luckily, the weather was cooperating, with a fine spring in full bloom. So she sent them out to the garden, to weed or plant or just walk around. Her office overlooked the garden, so these excursions had the added bonus that she could surreptitiously keep an eye on the two of them.

Alice didn’t know what kind of conditions Dan had been held in for the past five years. But she assumed it had not included much outdoor space, based on Dan’s reaction the first time he walked through the garden. Even from a distance, she could see that he was beholding everything, from the sunshine to the flowers to the insects, in pure wonder. Harry, walking beside with a steadying hand, was beholding Dan in much the same way.

During the garden visits, she could see that Dan was speaking to Harry. In fact, it looked like they had a fairly intense conversation one afternoon while weeding the garden. It was good that Dan was talking to somebody, and it made sense that that someone was Harry. But Dan had still not said a single word to Alice. She had asked around, and none of the other staff had heard him speak either. Alice needed to evaluate his mental state so she could plan his treatment, but that required talking to him. So she decided to enlist Harry’s help. As he was leaving the hospital at the end of the day, she stopped him and asked him if he would encourage Dan to participate in therapy sessions. Harry agreed readily enough, seeming eager when she mentioned the possibility of being able to discharge Dan for outpatient treatment before too long.

A couple of days later, Dan was escorted into Alice’s office for their therapy session. “Good morning, Dan,” Alice said. Dan always stared blankly whenever she said his name, as if it took him a moment to realize she was talking to him. Alice found that a bit strange, but maybe it was just because it had been so long since anyone had called him by his name. “How are you this morning?” she asked, not really expecting an answer.

But she got one, in a low, flat tone. “All right, I suppose.”

“Good.” Alice showed no outward surprise at finally hearing her patient speak. Apparently, Harry had succeeded in convincing Dan to go along with the therapy. Of course, the way Harry was currently the center of Dan’s world, he could probably convince him to do anything. “Can you tell me a bit more about how you’re feeling in general these days?” Alice went on, keeping it open-ended.

Dan appeared to give the matter some thought, as if he hadn’t considered it before. “I don’t know. Empty, mostly.”

Alice made a note of _hopeless affect_. “You’ve experienced a great deal of trauma. Are you aware of what’s happened to you?” She had sometimes seen post-psychotic patients who experienced memory loss.

“Yes, I’m aware.” A note of bitterness had crept into his voice. “Do we have to talk about that?”

“No. We can talk about whatever you’d like.” Silence followed, indicating that there was nothing he’d _like_ to talk about. So she asked, “Why don’t you start by telling me a little about yourself?” More silence. “For instance, where are you from?”

“Philadelphia.” No more elaboration on that.

“And what are some things you enjoy doing?”

“I used to enjoy my work. Before, I mean. I enjoyed the challenge of it. And it involved a lot of travel. That was something else I enjoyed. Discovering new places, meeting new people.”

Alice remembered that Harry had told her that Dan used to work in law enforcement, like him. She didn’t think cops traveled for work that much, but it wasn’t something she knew a lot about. Anyway, the details didn’t matter; what mattered was that Dan was at least saying something about himself. So she just affirmed, “I can see how that would be rewarding. What else?”

“I was mostly occupied by work. In my free time, I studied Tibetan Buddhism.”

That came out of left field. Never mind travel, she was pretty sure most cops did not spend their free time studying Tibetan Buddhism. But it seemed that Dan Carter had been no ordinary cop. _Highly intelligent_ , she wrote in her notes. That was consistent with how Harry had described Dan as well. “That sounds fascinating,” she said honestly. “I’d love to hear more about it.”

But Dan just shrugged, clearly not wanting to pursue the subject. “I don’t think it’s something I believe in anymore.”

“That’s too bad. Often, spirituality can help people get through difficult times.” No response. Alice noted that Dan had only spoken about himself in the past tense, as the person he used to be, as if that person no longer existed. He had lost interest in things that used to bring him joy. Another sign of depression. “And what about family? I know you and Harry are close, but do you have anyone else in your family who can provide support?”

“No. No one else.”

“So tell me about Harry.”

“Well, he’s the best man I know,” Dan started slowly. “Loyal to a fault, and with the highest integrity. He takes his duties seriously.” Alice nodded. That was the impression she had gotten of Harry. “He’s quite intelligent, more than he realizes. And also so wise. An old soul, as they say.” Dan’s voice was now more animated. “What I find most remarkable about him is that he presents himself as a simple man, what you see is what you get. And I think that’s how most people perceive him. But underneath that is the most exceptional mind and heart you’ll ever find. I’m in continual awe at the depths he contains.”

“Yes, I see what you mean,” Alice said. “He seems to have some layers.” She wrote in her notes, _strong bond with Harry_. However high the esteem Harry held for Dan, it was mutual. She added aloud, “It’s clear that he loves you very much.” She was sure Dan knew that, but it always helped to remind patients that they had people who cared about them and would stand by them no matter what, if they were lucky enough to have that.

But Dan said, “I wish he didn’t.”

“Why?” Alice kept her tone neutral.

“I don’t deserve it.”

“You deserve to be loved, Dan.” He didn’t say anything else after that. Alice made a note of _self-loathing_.

In the end, the diagnosis was obvious enough that a first-year psych intern could have done it. Post-traumatic stress disorder with comorbid depression. Not a surprising condition for someone who had just been held captive for five years by a serial killer. But Alice was hopeful that the outcome would be good. She immediately drew up a treatment plan involving sertraline and therapy. In the prognosis section, she noted that the patient’s condition was in response to an acute stressor rather than a chronic disposition, that he displayed considerable psychological resilience, and that he had strong support from a family member. All these factors were reasons for optimism about recovery.

* * *

Harry had been right: Alice did like Dan. She tried to like all her patients but didn’t always succeed. She _cared_ about all of them, but some of them were damn hard to like. In some cases, their illnesses made them difficult to deal with. In other cases, they were just jerks, independently of their illnesses. But she didn’t have to _try_ to like Dan. He was polite, for starters. He always thanked her sincerely at the end of their sessions, even if all she had done for the past hour was just try to get him to talk. And he was every bit as intelligent as she had initially thought. He was curious about things, albeit in a desultory sort of way. While trying to establish rapport, Alice would often make small talk about innocuous topics, like the pending plan to reintroduce wolves to Idaho or a book she had just read about the linguistic theory of universal grammar. Dan would sit so quietly that she wasn’t even sure if he was listening, but then the next day he would come back with an insightful question or connection to the topic they had been discussing the day before. Alice noticed him studying the Spokane and Nez Perce art she kept around her office, so she suggested he visit the cultural museum in town once he was out of the hospital. Dan didn’t look like he quite believed that would ever happen, but he just nodded and said he would be sure to do so.

Harry had also been right that _everyone_ liked Dan. He was nice to the nurses, learning their names and asking how their days were going. Accustomed to taking all kinds of abuse from patients, the nurses adored him. He also made small talk with the orderlies and custodians, who were so used to being ignored by patients and medical staff alike that they immediately adopted Dan as their favorite patient of all time. Dan didn’t interact much with the other patients, but he was never demeaning to them, not even to the ones who spent hours screaming at unseen others in the common room until one of the other patients yelled at them to shut up. Even Alice sometimes felt like screaming _shut up_ when the unit got especially chaotic, but Dan was placid in the face of it all. Alice got the impression that she was seeing his normal personality dialed down to about one-tenth of its usual strength, but even that was enough to make him likable.

Dan showed no adverse reaction to the sertraline and did seem to experience some benefit. He at least acted more energetic and engaged with other people than he had initially. Of course, Harry’s continued regular visits were a major source of strength for Dan as well. Alice watched the two of them from her office window, birdwatching or gardening, and even from the distance she could see that Dan’s body language was more at ease when he was with Harry.

During of their morning therapy sessions, when Alice asked Dan how he was feeling, she was surprised to receive a real answer. “I’m experiencing some anxiety,” he said. “I’ve been thinking about what it was like inside.”

“Inside? You mean during your captivity?” This was the first time Dan had brought up his ordeal.

“Yes, that’s right.”

“Would you like to tell me about it?”

“It was – a room.” Dan paused, seeming to find difficulty in describing it.

So Alice prompted, “Were you in this room the whole time?”

“Yes. The whole time.”

So she had been right that Dan hadn’t been outdoors for the entire five years. “Were you alone?” she asked.

“No. Well, yes. There were others, sometimes. I talked to them. But they weren’t real.” His eyes darted to her, as if to gauge her reaction.

Alice nodded reassuringly. “Just so you know, hallucinations are a perfectly normal response to extended sensory deprivation and isolation. There’s nothing pathological about it.” Just as she had suspected, the closest analogue to Dan’s experience was prisoners who had spent years in solitary confinement. “What about your captor? Where was he during all this?” She might be pushing it too far with that line of questioning, but she needed to know whether he had suffered any additional abuse.

“Outside. But –” Dan seemed unsure of whether to continue, so Alice just waited. “Sometimes he showed me things.”

“What did he show you?”

“What he was doing. Outside. The killings.”

Confused, Alice asked, “You mean he took you to the scenes?”

“No. I never left the room. It was – on video. He would record it and show it to me.”

That was even more depraved than anything Alice could have imagined, but she just asked calmly, “And what was that like for you to see?”

“The first few times, it was terrible. But after some time had passed, I didn’t care anymore. I didn’t feel anything. They weren’t even real people to me anymore. I wasn’t a person anymore myself. And after a while, I didn’t even want to get out anymore. What I wanted was to just stop existing.”

Alice took that in. Dan had become detached from his feelings as a coping mechanism, but then developed guilt about his detachment. That was why he had engaged in self-harm and, apparently, had suicidal ideation. The next question was very important for his treatment plan, so she was careful to keep her voice and expression completely neutral as she asked, “Do you still feel that way now?”

“No, not like that.” He answered quickly, but not too quickly, at a tempo that had the ring of truth. Alice wrote in her notes _past suicidal ideation, claims none now_.

“What is it that you want now?” Another important question, to support the development of goals.

“I want –” He seemed puzzled, as if he hadn’t thought about what he wanted. “I want to become who I was before.”

“And why do you want that?”

Dan sounded lost as he answered, “It would make Harry happy.”

Right now, Dan’s own happiness seemed so out of reach to him that all he could think about was making Harry feel better. “In the long term,” she said, “you have to think about your own happiness. It’s not enough to live for someone else. You have to live for yourself.” Dan appeared dubious, so she went on, “We’ll work on that over time. But you should also know that you may not be the same as you were before, and that’s okay. Our experiences change us. An experience like the one you had would have a major impact on anyone. But you don’t have to be unchanged in order to find yourself again. You just have to find your core, that part of you that is so deep inside that nothing can touch it. And when you find it, you will feel like yourself again, and you will be able to experience joy and connect with the world again. And I think _that_ would make Harry happy.”

“All right,” Dan said slowly.

Given that she had finally broken through Dan’s barriers, Alice decided now was as good a time as any to gauge his reaction to his disfiguration. After all, she did need to talk to him about the reasons for the self-harm and assess whether it was a risk going forward. So she said, “There’s something else I have to ask you about. I assume you haven’t yet seen the wounds on your face?” Dan shook his head, and Alice asked, “Do you feel ready to take a look?”

Shrugging as if it was of no consequence to him, Dan simply said, “Yes.”

“Are you sure? The scarring is quite extensive. You may find it disturbing.”

Dan nodded seriously and said, “I’m ready.” So Alice handed him a small mirror. He took it and stared into it for a few seconds, then handed it back.

“Well?” Alice prompted.

“You’re right. The scarring is quite extensive.” Dan sounded like he was talking about damage to a flooded basement rather than his own face.

“And? Does that bother you?”

“Not really.”

“Why not?” His lack of reaction was a bit unsettling.

“It seems only fitting that the way I look on the outside reflects the way I feel on the inside.”

“And what way is that?”

“Damaged,” Dan said flatly.

“Is that why you inflicted those injuries on yourself? Because you felt damaged on the inside?” Alice felt that they were finally getting to the root of the issue. She had been puzzled by the unusual extent of the self-harm, and especially the fact that it was inflicted on the face, but now she could see how it had been a natural, if maladaptive, response to the way he had been feeling.

“Possibly,” Dan hedged. “I’m not certain why I did it. I wasn’t thinking clearly.”

Alice sensed that he was holding something back, but she asked the critical question regardless. “And have you felt compelled to hurt yourself since then?”

“No.”

Again, Alice believed that he was telling the truth, and after all he had made no further attempts at self-harm while in the hospital. So she said, “I’m glad to hear that.” In her notes, she wrote _No evidence of compulsion for further self-harm_.

“Well,” Alice said, closing her notebook, “I think that’s enough for today. You’re making great progress, Dan.”

He nodded and thanked her politely, as always, then went back out into the common room. Alice checked her calendar. Given that Dan no longer seemed to pose a danger to himself, it looked like he was on track for release to outpatient care soon. Beds were always in short supply, and administrators were always breathing down her neck to get patients out the door as soon as possible. Alice hated that those kinds of considerations had to go into her patient care, and there had been times when she had strenuously objected to release of someone who wasn’t ready. But in Dan’s case, she felt more confident than usual that he would do well in outpatient care. She was certain that Harry would continue to provide support, and that was the kind of thing that led to healing.


	6. Chapter 6

When Alice brought up the idea of release to Harry, he seemed surprised, then excited. As she had expected, he immediately suggested that Dan stay with him, and listened seriously as Alice outlined the responsibilities involved. Alice felt more confident about Dan’s transitional plan than she ever had for just about any other patient.

Dan’s reaction was less positive. Alice was initially taken aback when he showed reluctance to the idea of staying with Harry, asking instead if he could get his own place. But she understood when Dan mentioned not wanting to be a burden. It was common enough for patients to worry about the impact of their mental illness on their loved ones. She managed to convince Dan to agree to the plan.

In the planning meeting she held with Dan and Harry, Alice brought up the reconstructive surgery. It would be an ideal time to get it done, now that Dan was psychologically stable enough to comply with post-operative instructions, but before he started spending time out in public. She was surprised when he politely, but definitively, shot the idea down. When she asked why he didn’t want the surgery, he took a long time to answer.

“There’s no wrong answer, Dan,” Alice said. “Whatever you’re feeling is okay.”

Dan looked at Harry. Alice wished she had asked him when he was alone, because clearly he didn’t want to say whatever it was in front of Harry. “I don’t want to be myself anymore,” Dan said finally.

Harry looked devastated at that. He stayed with her after Dan had been dismissed from the meeting, to ask her if it was a cause for concern. Alice couldn’t deny that it was, but she still felt that Dan would do better in an outpatient environment, in Harry’s custody. So she reassured him as best she could, promised to share some support strategies on Monday, and then went home for the weekend.

On the drive home, Alice remembered that her fridge was empty, so she stopped at the grocery store to buy a few things. In the checkout line, her eyes drifted over the magazine rack. Suddenly, something in the corner of her eye caught her attention, and she did a double-take. She saw the face of the Twin Peaks Killer, on the cover of a trashy tabloid, next to a headline reading “Exclusive: Leaked TPK Audio Tapes Reveal Shocking New Details of Case.” But what had caught her eye initially was not the Twin Peaks Killer’s face. At least, not all of it. Alice picked up the magazine and stared into the killer’s eyes, realizing that there was something familiar about them.

With some embarrassment, Alice tossed the magazine onto the belt with the rest of her purchases. When she got home, she heated up a TV dinner, then sat at her kitchen table to read the article. She wasn’t sure why she had even bought the tabloid in the first place. Although she had followed the case through the TV news, she had never even considered reading a tabloid before, especially not one that was shamelessly profiteering off people’s suffering by finding new and creative ways to revive a news story that had been over with for months. But something in the killer’s eyes had drawn her, and she couldn’t resist.

In addition to being in poor taste, the headline had seriously oversold the supposedly shocking new details. The article explained that the Twin Peaks Killer, aka FBI Special Agent Dale Cooper, had kept Dictaphone notes of all his cases. An anonymous source had leaked to the tabloid the audio recordings Agent Cooper had made in Twin Peaks during the weeks leading up to his first kill. As the article reluctantly conceded, most of the content of the recordings was completely innocuous. It consisted of notes Cooper had made regarding the case he had been investigating on behalf of the FBI, which involved the murder of a local teenage girl. But the article went on to point out a few interesting tidbits contained in the recordings. First, it seemed that Agent Cooper had been a deeply weird guy. Not in any overtly sinister way, just weird. For example, he had recorded a number of off-topic musings, at great length and with great enthusiasm, on everything from the water pressure in his hotel room to the height of the trees along the highway to the quality of the pie in the local diner. The article noted that a remarkably large proportion of Agent Cooper’s recordings concerned coffee, with which he was apparently obsessed.

While reading, Alice began to feel the chill of ghostly fingers tracing her spine. It was that familiar unease she always associated with Twin Peaks, but now it was taking a more definite form. She remembered little details Harry had told her about Dan. That he got excited about little things, like _trees_. That he was the world’s biggest coffee addict. Harry hadn’t actually told her about Dan’s love for pie, but she had inferred it from the fact that Harry never failed to bring Dan a slice. The fact that Dan apparently had these small, insignificant things in common with his captor was an unsettling coincidence.

Continuing to read, Alice got a major shock. The article noted, with some bemusement, that Agent Cooper had also talked about applying principles of Tibetan Buddhism to solving crimes. Her mind boggled. _That_ couldn’t be a coincidence, could it? She remembered thinking that Dan must be the only law-enforcement officer in the world who spent his free time reading up in Tibetan Buddhism. Maybe he wasn’t the only one. Or, her mind suggested with growing discomfort, maybe he was.

The final kicker came in the last paragraph of the article. In a desperate bid to make the recordings seem more ominous than they really were, the reporter had written, “The tapes also provide evidence that Agent Cooper was making concerted efforts to ingratiate himself with the local community, perhaps in a bid to gain their trust in preparation for his later crimes. For example, he spoke frequently and positively about then-Sheriff Harry Truman, with whom he had apparently developed a close working relationship and personal friendship.”

Alice put down the magazine, her head spinning. She hadn’t been following the case that closely, but she had thought she had seen the Twin Peaks Sheriff on TV a few times during press conferences. He was a Nez Perce guy, Hale or Hill or something like that. But the article had said that Harry Truman was the _then_ -Sheriff, during the time leading up to the killings. It couldn’t be the same Harry Truman, could it? But how many Harry Trumans were there, other than the obvious? As she thought back, she realized that she had assumed that Harry was originally from Missoula, although he hadn’t ever actually said that. But if he was the former sheriff of Twin Peaks, if he had known and worked with and even befriended the man who would later kidnap and imprison his cousin, why the hell hadn’t he ever mentioned that to her?

Alice stared again at the face on the cover of the magazine, at the eyes she was beginning to recognize. None of this made any sense. She was missing something. Maybe, she thought suddenly as she picked up the tabloid and began flipping through it again, what she was missing was reliable information. After all, the TPK article was sandwiched between one headlined “Elvis Is Alive and Living on the Moon” and another proclaiming “I Married Bigfoot (and I’m Having His Baby!)”. The tabloid could have made up the entire audio recordings story out of whole cloth. That seemed much more likely than the other ideas that had crept into her mind. She resolved that she would do some research in the morning and find out a logical explanation.

Despite having committed to this plan, Alice had a restless night. She dreamed that she was standing in an empty village. From behind, a man’s shadow fell across her, and she turned to look at him, but there was no one there. Then a woman’s shadow appeared, and a child’s. More and more human-shaped shadows appeared, all without any humans to cast them. Soon, there was a whole village populated by shadow-beings, dancing, fighting, writhing in pain. Alice turned around and around to try to find the source of the light, but all she saw were two mountains crouching on the horizon. The mountains’ shadow crept toward the village like the approach of night, and one by one the shadow-beings disappeared as they were subsumed into the larger mountain-shadow. Then the mountain-shadow passed over Alice, and she could feel herself also dissolving away into darkness.

Alice woke up with morning sunlight streaming through her window, but the darkness from her dream was still heavy against her eyelids. Trying to shake it off, she got up. It was her day off. She showered, got dressed, drank coffee, ate breakfast. Then she headed to the Spokane public library.

Alice explained to a helpful librarian that she was researching the Twin Peaks Killer case and that she needed to find local newspaper coverage during February and March of 1989. Probably assuming that she was a grad student or something, the librarian pulled the relevant microfiche cards and showed her how to load them into the machine. Alice spent the whole morning scrolling through old issues of the _Twin Peaks Gazette_.

It wasn’t difficult to find articles on the Laura Palmer murder, the case that had initially brought Agent Cooper to Twin Peaks. The paper had seemingly covered little else. Alice didn’t read those articles in detail, instead scanning the pages for any mention of Agent Cooper or Sheriff Truman. She found the first mention of both in the issue that came out the day after the murder, in a short item that noted tersely that the FBI had dispatched Special Agent Dale Cooper, based out of the Philadelphia field office, to investigate, and that he would be working with the full cooperation of Sheriff Harry Truman and his department.

Philadelphia. Dan had mentioned that that was where he was from. And he had said he used to travel a lot for work. That sounded like someone who worked for a federal rather than a local law-enforcement agency. Slightly displeased that reliable sources were confirming rather than refuting the impossible, ridiculous ideas she had been having, Alice continued searching.

The next article that jumped out at her was dated about a week after Agent Cooper’s arrival in Twin Peaks. It was another short item, noting that FBI Special Agent Dale Cooper had been shot by an unknown assailant in his room at the Great Northern Hotel. He had been wearing his tactical vest at the time, but one of the bullets had entered his abdomen, causing minor injury. The article’s tone was remarkably casual about the incident, as if things like that happened in town every day. With a sinking feeling, Alice remembered the gunshot wound scar she had seen in Dan’s abdomen. Still, she kept looking, still desperately hoping that she would find something that would make her whole carefully constructed mountain of evidence fall apart.

What finally convinced her to accept the whole impossible, ridiculous idea was not an article from the Twin Peaks Gazette, but one that had somehow snuck into the library’s archive from the _Steeplejack_ , the student newspaper at Twin Peaks High School. Following the closing of the Laura Palmer case (it turned out the poor girl had been killed by her own father), the students had put together a somber special edition commemorating their dead classmate and the investigation of her murder. One of the articles featured a quote from Sheriff Harry Truman: “My hope is that now we can start to heal as a community. And I’m grateful to the FBI for sending us Special Agent Dale Cooper to lead this investigation. His skill and dedication are what solved this case.” Scrolling down further, Alice saw that the student reporters had included a photo beneath the fold. Two things about it struck her immediately. First, it was the only photo she had managed to find of Sheriff Truman, so she could finally confirm that he was indeed the Harry she knew and not some other guy improbably also named after the same president. Second, Agent Cooper was also in the photo, and Harry was staring at him with the exact same hero-worshipping gaze that he always bestowed on Dan.

Alice leaned back in her chair. That was it. It was impossible, and it was ridiculous, but it was also, somehow, true. Special Agent Dale Cooper and her patient Dan Carter were the same person. And since Special Agent Dale Cooper was the Twin Peaks Killer, a simple application of the transitive property meant that her patient was the Twin Peaks Killer.

Immediately, she felt a visceral reaction against the conclusion she had reached. First, and most obviously, the Twin Peaks Killer was dead. No one disputed that. Not even the tabloid she had bought at the supermarket was suggesting that the TPK was alive and well, hanging out with Elvis on the moon. The authorities seemed quite confident that they had shot and killed the killer, and that seemed like the kind of thing they would know. So either the current sheriff and the FBI had been fooled somehow, or they were in on it. Whatever _it_ was.

That wasn’t even her primary objection, though. The Twin Peaks Killer was a psychopath. Dan, her sweet and considerate patient, was not a psychopath. Of course, better psychiatrists than her had been taken in by psychopaths. That was in the very nature of psychopaths. They were incapable of feeling empathy, so were totally ruthless in pursuing their objectives. But they were often highly intelligent and charming, and understood human behavior with such detached objectivity that they could easily manipulate it. Dan was certainly intelligent and was quite charming when he wasn’t completely crippled by his depression, but he showed no signs of psychopathy. He felt empathy, she was sure of it. Even if he was faking it by pretending to be nice to her and the other staff and patients, there was no way he was faking it with Harry. There was no doubt in her mind that he loved Harry. And not in the selfish way that psychopaths sometimes fixate on other people, as an instrument for achieving their own desires. It was real love, as an end in itself. He showed in the way his posture relaxed in Harry’s presence, the way his eyes were drawn to Harry, the way his voice softened when he talked about Harry. Not even the most devious psychopath could imitate that depth of emotion.

And then there was Harry himself. Amidst all the evidence she had amassed, it was clear that Harry had known what was going on, whatever it was. It was, of course, possible that Harry had fallen under the spell of a charismatic psychopath, as Alice herself possibly had. But again, she couldn’t believe that. Harry was no fool; he struck her as one of the most level-headed people she had ever encountered, his drinking problem aside. And while Dan’s mind was something of a black box, Harry was an open book. She felt she had gotten to know him pretty well, and the two most basic facts about his character were that he was a good man, and that he worshipped the ground Dan walked on. Harry had dedicated his life to keeping people safe. He had dropped everything to be there for Dan. Harry hadn’t been acting like someone who was covering for a mass murderer. He had been acting like someone who was desperately trying to save an innocent.

Maybe _that_ was what she was missing. Even though Dan was really Dale Cooper, maybe Dale Cooper wasn’t really the Twin Peaks Killer. Alice pondered the implausibility of that scenario for a moment. There had, after all, been multiple eyewitnesses and at least some photographic evidence confirming that Agent Cooper had committed the murders. So unless he had an evil twin –

Suddenly, a voice echoed in Alice’s head, a voice that sounded like her grandmother’s. The voice said _kon_ _á cim_ _úuxcimux wis_ _éekey’x_. That was in the language of the Nez Perce, which Alice didn’t speak. Theirs was a Sahaptian language, whereas her own people, the Spokane, spoke a Salish dialect. But the translation sprang unbidden to her mind, also in Gran’s voice. _Where shadows walk_. That was what the Nez Perce had called the area that was now Twin Peaks. Alice could remember now that Gran had told her the story when she was a little girl. But it was like a memory of a dream. The more she tried to recall the details, the more they slipped away.

Alice gathered up all her microfiche cards to return to the librarian. She was done consulting psychiatry reference books and old newspapers. She had gotten all the answers she would from those sources. To gain a deeper understanding, she needed to do a different kind of research. She went back out to her car and made the hour-long drive northwest to the Spokane reservation.


	7. Chapter 7

Alice pulled up in front of her grandmother’s house, perched on a bluff above the Spokane River. As she got out of her car, she could hear the snowmelt-swollen river making its tumultuous way down towards the Columbia, its energy about to be sapped by the reservoir impounded by the dam a few miles downstream. Alice walked up to the house, beneath the massive ponderosa pine she had played under as a child. Gran opened the door before Alice had even stepped onto the porch.

“I thought you weren’t coming until tomorrow, little one,” Gran said unceremoniously.

“I wanted to see you today, Gran.”

Gran held the door open and gestured impatiently for Alice to come inside. “I’ve got tea ready, and food.”

Alice sat at the kitchen table while Gran poured her a cup of tea and set out a plate of smoked salmon and fry bread. Even though she wasn’t really hungry, Alice took a few bites. Gran always expected her to eat something, and anyway Alice enjoyed the taste of home. When she was on the reservation, she felt that all the cells of her body had come from this place, the land and waters that had sustained her people since the glaciers retreated into the mountains.

“What’s the matter, little one?” Gran asked abruptly, sitting down across from Alice with her own cup of tea.

“Nothing,” Alice said automatically, then added reluctantly, “Just some trouble I’m having with a patient.”

“Hmm.” Gran sipped righteously at her tea. “Those patients of yours. You lock them up in prison and poison them with your so-called medicine, then you wonder why they’re still crazy?”

Alice sighed. This was an old argument between them. “It’s not a prison, it’s a hospital. And the medications help a lot of patients.” Gran looked like she was going to argue some more, but Alice didn’t have the energy for it, so she quickly changed the subject. “Gran, I came today because I want to hear one of your stories.”

Gran looked at her askance. “You haven’t asked to hear one of my stories since you were knee-high. Even back then, you only half-listened. Always playing with your chemistry kit or something.”

“I know.” Alice felt a twist of guilt. When she was a kid, all she had wanted was to get off the res. So she had studied hard, gone to college, then to med school. She had been eager for knowledge, the kind they taught in school. But now, looking at her grandmother’s face, ancient and furrowed as the bark of the pine tree outside, she realized she had lost a lot by detaching herself from her homeland, from her people and their knowledge. Their medicine. “But I want to hear your stories now.”

“Before I die, you mean.” Gran’s tone was matter-of-fact.

Alice sighed. “Gran—”

“No, it’s all right. This is the way it’s always been. The young don’t listen to their elders, until they grow up and start to know better. You’ll find the same thing with your own grandkids, when you’re my age.” Gran’s face crinkled into a smile. “What do you want to hear about, little one?”

“I want to hear about Twin Peaks. Where shadows walk.”

“You remember me telling you about that?”

“Sort of. I’ve been thinking about it lately. I’d like to hear it again.”

Gran nodded. “I’m glad something I told you back then stuck in that head of yours. All right.” Gran took another sip of tea in preparation. “You know, you have some Nez Perce ancestors. My grandfather married a Nez Perce woman.”

Alice nodded. Many of Gran’s stories began this way. It was important to tell the story of the story, as it were, to trace its provenance and how it had been handed down through the generations.

“It was her, my Nez Perce grandmother, who gave me their language. And she gave me this story. She was a little girl when this happened. So it was four generations ago, before the railroad came, before the wars and the reservation, when the only white men around here were the ones trapping beaver.

“There was one band of Nez Perce who had the most powerful shaman any of the Plateau tribes had known in ten generations. He was still only a young man, but the elders said he was destined to become maybe the greatest medicine man of all time. This band made their summer hunting camp up in a meadow between two mountain peaks, where the elk came to graze the new grass. Everyone knew not to go too deep into the woods around there, because that was where the two Lodges were. The White Lodge and the Black Lodge. Love was the path to one and fear was the path to the other. They were both powerful, but dangerous. So the people knew to stay away.

“Well, this young shaman, when he was up at the hunting camp one summer, he felt the Lodges calling to him. Visions came to him, in dreams, in swirls of woodsmoke. Everywhere he looked, he saw strange folk, the Lodge-dwellers. He spoke with them. They offered him power, and he wanted it. Not for himself, but for his people. He knew the danger, but he believed down to the core of his being that he was strong enough to find the path to the Lodges and back out again.

“So, one night, when the stars told him that the time was right and the door to the Lodges was open, he walked inside. Days went by, and he didn’t come out. His people mourned him, thinking the Black Lodge had taken him for good.

“After a few days, he did come back out. But he was different now. There was a dark gleam in his eye that hadn’t been there before. Soon, the people started finding dead elk calves out in the meadows. The calves’ bodies were torn from throat to belly, guts ripped out, limbs scattered around. No one knew what kind of beast was doing it. Neither wolf nor bear nor mountain lion would just leave a kill out to rot like that. What was stranger still was that scavengers wouldn’t touch the carcasses. Not ravens, not coyote. Even flies wouldn’t land on them. It was like all the carrion-eaters knew that the flesh was poisoned somehow. So the people took all carcasses they found and burned them to ashes and threw the ashes into the river.

“One of the young women had a newborn, and it disappeared, taken from her arms while she slept. The people searched everywhere and found the baby out in the meadow, killed and mutilated just like the elk calves. The shaman was nowhere to be found. The elders met in council with the chief. Things were tense. The elders said this evil had come upon them because the shaman had violated the taboo by going into the Black Lodge. They said it was his shadow that had come out. They knew that the Black Lodge could do that, make a shadow that walked free. It had happened before, long ago, and now it was happening again. The chief sent the best hunters out into the woods, but they couldn’t find the shaman anywhere. All that long summer, the shadow haunted them. People went missing, men, women, and children, only to show up in pieces. In the dying days of summer, the chief’s own daughter disappeared. The hunters searched all day and all night, and they finally found her. Not only that, they found the young shaman crouching over the girl’s body, painting his face with her blood. The hunters chased after him. The chief’s son was the strongest hunter of them all, and he was hell-bent on revenge for his sister’s death. He put an arrow through the shaman’s back, finally killing him. The people mourned again, for all the ones they had lost. Then they packed up their camp, because it was time to start the journey to their winter village down at Celilo Falls.

“The night before they were set to leave, a wild thing came out of the woods. It was the young shaman. He couldn’t speak. He had forgotten how to be human. Taking pity on him, the people brought him with them when they moved camp. Days and miles went by before he could speak again. When he did, he told them that he had seen everything, all the horrors that his shadow had carried out against his people. He was driven half-mad with grief and self-loathing.

“Out of compassion, the chief’s son took the shaman on a detour down here to the Spokane lands. In a gesture of goodwill, our people let them come to Medical Lake. Those lake waters were the strongest medicine on the Plateau, and the chief’s son hoped that they would heal the shaman’s spirit so that he could once again be the powerful man he had been. But the moment the shaman touched the water, the whole lake turned black and foul. The Spokane people chased them off, and it was another generation before we let outsiders near Medical Lake again.

“The shaman and the chief’s son rejoined the rest of their people at Celilo Falls. The shaman had lost his speech again. He spent all his time on the basalt ledge above the falls, staring into the churning whitewater at its base like he could see straight through to the other side. One day, the men on the dipnet platforms below the falls looked up to see a shape hurtle off the ledge and disappear beneath the roiling rapids. The shaman had thrown himself off the falls.

“When the people went back to the mountains the next summer, they made their camp further down in the valley. They didn’t venture into the space between the two peaks, leaving that land for the spirits who dwelled there. And they left it that way for years to come. So that they wouldn’t forget, the people named the land between the peaks _kon_ _á cim_ _úuxcimux wis_ _éekey’x_. Where shadows walk.”


	8. Chapter 8

Alice stared up at the moonlight angling against the wall above her bed. She was having yet another restless night. Now the mystery of what had happened was solved, but she still had to face the bigger mystery of what she was going to do about it.

The part of her that had studied science and medicine rebelled against the notion that her patient had suffered at the hands of malevolent spirits. But the deeper part of herself, the part that had been shaped by the rivers and rocks of her homeland, knew it to be true. What had happened to Dale – Dan had become Dale in her mind – was something that had happened before to others. It was an old story, one that the Nez Perce knew so well that they had inscribed it onto their map of the landscape. What was more, this story fit in with who she knew Dale and Harry to be. Dale was an innocent who had suffered through unimaginable horrors, who had torn off his own face because he had seen it become the face of a killer. And Harry was his protector, who had devoted his life to making sure that Dale didn’t have to suffer for things he hadn’t even done.

The question remained, though, as to how she should proceed with Dale’s treatment plan. The idea of “treatment” seemed laughably inadequate now that she understood what Dale had experienced, but she was still his psychiatrist, and she still had a responsibility to treat him to the best of her ability. Dale’s planned release date was only a few days away. If she were to postpone his release, she would need a reason. There was no way she could justify a delay based on having just discovered that Dale had been trapped in an otherworldly realm while his evil doppelganger went on a killing spree. She would need to put that in writing as documentation, and then _she_ would be the crazy one.

It occurred to her that there was really no reason to delay Dale’s release, anyway. Nothing about the situation had changed, other than her understanding of it. Her assessment had been that Dale did not pose a danger to himself or others and that his prospects for recovery would be improved in an outpatient setting. That was still her assessment. If anything, she believed even more strongly that staying in the hospital for would be counterproductive for Dale. He had been a prisoner for so long. He needed to be free, and he needed Harry.

So that answered the treatment question. She would proceed as planned. But, she wondered, should she _say_ something to Dale and Harry? As soon as the thought occurred to her, she rejected it. Her job was to listen. If either of them ever felt like talking to her about the Black Lodge or the shadow-Dale, she would be all ears. But until then, she would continue to outwardly take their cover story at face value.

Once those decisions were made, Alice immediately relaxed. She had nothing more to wonder or worry about, just a job to do, the same job she did every day. She would do whatever she could to make Dale’s road to recovery smoother. Finally at peace with what she was doing, she drifted off and slept soundly all night long.

* * *

Often, Alice had mixed feelings about releasing a patient. On rare occasions, when someone truly had made a miraculous recovery, she felt only joy on their behalf. Or, if it was an especially difficult patient, relief at seeing them go, mingled with guilt. Most often, she felt some amount of trepidation in releasing patients, especially if the release had come about as a result of pressure from above to free up beds. She worried that she would see them again in a few days when they would be immediately hauled back to the hospital after not being able to cope with the outside world. Or, worse, that she wouldn’t see them ever again, because they would use the lessened supervision as an opportunity to end their lives.

With Dale, she wasn’t entirely sure what she felt. She had been diligent about preparing him with stress-relief techniques and making sure that Harry knew the red flags and setting them up with social workers and therapists and prescriptions. She was confident that she had done all she could to ease the transition. And she believed fervently that Harry would take good care of Dale. So she wasn’t worried, exactly. But nor was she joyous. There had been no miraculous recovery, after all, and she was no longer sure that what afflicted Dale was the kind of thing one could recover from. And there was a melancholy note underlying all those more complex feelings, resulting from the simple fact that she would miss them both. She gave them a business card her personal phone number. Normally, that would be unthinkable, but she was willing to make an exception for them. She wanted to be there for them in case the shadows came walking again.

After they left, the unit seemed empty to Alice for a few days. She would reflexively walk by the visitation room at 3 pm, only to remember that Harry wasn’t there, or would find herself staring out at the garden from her office window, looking for Dale’s sunhat. But then the daily adventures of life in a psychiatric hospital took over her attention, new patients came in, and she no longer spent so much time thinking about Dale and Harry.

So she was surprised when, just a few weeks after Dale’s release, she got a call from Harry. He asked if she remembered him and Dan, as if she could have forgotten them. He sounded worried. She was surprised, because she had been checking in with the outpatient therapist she had referred Dale to, and all had seemed well. But she suggested that Harry bring Dale to the hospital so she could speak with them both, and he agreed.

Alice spoke first with Dale, then with Harry. It quickly became clear what the problem was. The two of them were developing a codependent relationship. It wasn’t really surprising, given what they had been through together. Alice still didn’t understand exactly what they were to each other, but based on the research she had done, they had worked together and become friends in Twin Peaks while Harry was the sheriff and Dale was an FBI agent. They had apparently gotten close unusually fast; it seemed that Dale had only been in town for a few weeks before everything went to hell. And she got the sense that Harry held himself in some way responsible for what had happened to Dale. He told her as much while they were speaking alone during their impromptu therapy session, while Dale waited outside.

“I saw Dan right before – “ Harry said, then paused as if looking for the right words. “Before he disappeared. I might have been able to do something that would have changed things, but I was stuck with the way things turned out. And then, for five years, I thought he was dead, and all that time I had to hear about the Twin Peaks Killer all over the news. And all I could think about was how much I wished I had done something different, and how much I wanted him to come back.”

As he spoke, Harry’s features twisted as if in physical pain. Alice realized that, as much as Dale had suffered, Harry’s torment might have been even worse. She wasn’t sure what he thought he could have done differently. She didn’t know the circumstances that had led up to Dale’s imprisonment in the Black Lodge, but her impression was that Dale had been like the young shaman in Gran’s story. He had gone into the Lodge willingly. Maybe that was the only way in. If so, probably nothing Harry or anyone else could have done would have stopped him. But, regardless, Harry had clearly been haunted by his self-perceived failure to save his friend. And, Alice realized with horror, Harry hadn’t known about the shadow selves produced by the Lodge. All he had known was that Dale had gone into the Lodge and a monster wearing his face had come out. Harry must have assumed that the Lodge had somehow made Dale evil. That was even worse than believing that he was dead, and Harry had lived with that for five years, getting regular news updates on the Twin Peaks Killer’s latest crimes. No wonder he had relied so heavily on his coping mechanism of alcohol during that time. It was clear from how Harry talked about Dale, and even just from the _Steeplejack_ article Alice had read in the library, that Harry idolized Dale as a paragon of virtue. To see Dale debased as a brutal killer must have been torture for Harry.

And then Harry had been given the greatest gift he hadn’t even dared to hope for. He had gotten Dale back. It was a hurt and damaged version of Dale, but Harry had clung to him with desperate hope and hadn’t dared to let him go for even a second for fear of losing him again. Now Harry spent all his time and energy trying to heal Dale, to make him happy again.

Looking at the situation from Dale’s side, Alice saw how much Harry’s unconditional support must have meant to him. Dale had come back to a world in which the only solid thing, the only thing he recognized, was Harry. Over time, Dale had come to realize how dependent he was on Harry, and now he was experiencing guilt over how that dependence was affecting Harry. Dale had obviously picked up on Harry’s strong desire for his recovery, and now he was stressed about his perceived lack of progress because it meant he was failing to fulfill Harry’s wishes. The whole dynamic was tailor-made for codependency.

Alice felt that she had analyzed the relationship dynamics accurately, but at the same time she had the sense that this clinical description was missing something. Like everything in psychiatry, codependency existed on a spectrum. On the pathological end, it could lead to controlling or enabling behavior. But she didn’t see any of those destructive elements in Harry and Dale’s relationship. All she saw was love. In its more benign forms, codependency was pretty much synonymous with love. What, after all, is love, if not dependence on another for one’s own happiness? It might be painful, but that was part of love too. The line that separated love from a pathological condition was a blurry one.

Despite having deeper knowledge of the underlying dynamics then she was able to let on, Alice provided Dale and Harry with standard advice for mitigating codependency. Harry needed to provide Dale with space to process his feelings on his own, and he also needed to have his own support system. And they both needed to make a better effort to communicate their own feelings. She tried walking them through how to do that, but they both seemed overwhelmed by the depth of what they were feeling and struggled to put it into words. Regardless, she sent them on their way, reassured that they were at least making an effort to adjust their behavior. That was all she could ask them to do, since it was clear that their fates were tied together.


	9. Chapter 9

The summer dragged on, hot and dry and dusty. On the hottest day of the entire year, Alice arrived home from work to find the air still shimmering with heat despite the onset of evening. As she entered her house, which was warmed up inside like a brick oven, she thought about walking down to the river to cool off. That thought was dashed when the phone rang. Picking it up, she answered, “Hello?”

“Doc, it’s Harry Truman.” The last time Harry had called her, he had sounded worried. Now, he sounded panicked. “I’m sorry to call you at home, but I didn’t know what else to do –”

“It’s okay, Harry.” Alice felt a knot of apprehension in her stomach. “Just tell me what happened.”

“Coop – _Dan_ is gone.” If she hadn’t already been sure of Dale’s true identity, that little slipup would have been all the confirmation she needed. Harry was usually so careful about maintaining Dale’s cover story, so the fact that he had inadvertently called him by his real name was a sign that he really was panicking. “I came home from work and he wasn’t here in the apartment. But the TV was on, and it was a show about the Twin Peaks Killer, and I think he saw it and ran off somewhere, and I don’t think he’s even wearing shoes –”

“Do you have any idea where he might have gone?” This was not good. Patients suffering from PTSD sometimes had severe reactions to triggers, and seeing footage of what his shadow self had done while he was in the Black Lodge would certainly qualify as a trigger.

“Yes, I had lots of ideas, but I already checked, and he’s not in any of those places.”

“Tell me more about this TV show.”

“I don’t know, I only saw about ten seconds of it, but they were showing the picture of – of the killer, and the crime scenes, and stuff like that.” Harry sounded shaken. His own trauma had been triggered by what he had seen.

“And how long has he been gone?”

“At least an hour. It looks like he left in a hurry, he didn’t even close the door.”

That didn’t bode well for Dale’s mental state. Alice was worried that he might hurt himself, intentionally or not, so there was only one thing she could do. “Okay, Harry, I’m going to call the police and notify them to be on the lookout for him.”

“Are you sure that’s a good idea?” Harry obviously didn’t think it was. “I know cops, they can get a bit carried away –”

“We have a good relationship with the local law enforcement agencies. They’ve often been helpful in tracking down patients who need help.” Alice understood why Harry was so reluctant to involve the police. Quite aside from his legitimate point that the police sometimes overreacted to people experiencing mental-health crises, she knew he had to be worried about any amount of official scrutiny of Dale, lest it lead to his true identity being uncovered. But there really was no choice here. She went on, trying to be gentle but firm, “And I think Dan needs help right now. If he saw that TV show, it almost certainly triggered his trauma, and it’s possible he may be endangering himself right now.”

“And if I hadn’t followed your advice about leaving him alone during the day, this wouldn’t have happened.”

Alice felt a momentary flash of anger. _You’re going to blame me for this? If you had any idea what I’ve really done for you both …_ But she suppressed the feeling. Harry was just projecting his fear and guilt into anger at her. Transference again. But the fact that it got to her told her that she was feeling her own guilt about not seeing this coming. If anything happened to Dale, she would never forgive herself. She had thought that he would be able to do what none of the others who came before him had done, to walk free of the Black Lodge. But maybe she had been deluding herself about that, by treating Dale like any other patient when she knew full well that his very soul had been taken from him. And Harry had trusted her. She would never be able to face him if they didn’t find Dale safe.

Harry immediately apologized for snapping at her, and he sounded sincere about it. Alice waved it off, telling Harry she needed to get off the phone so she could call the police. She dialed Spokane PD and explained the situation to the desk sergeant and provided them with Dale’s description. She emphasized that the missing man was a psychiatric patient who was unarmed and of no danger to the public, so there was no need to use force on him. The sergeant agreed to share the bulletin with other agencies in the area, and Alice hung up.

She stood in the kitchen for a moment, taking a deep breath. Then she headed out to her car. She didn’t want to hang around her house all evening, waiting for news of Dale. She would go to the hospital instead. That way, she told herself optimistically, when they found Dale, she would already be there to examine him and make sure he was okay.

She had been at the hospital for a couple of hours when she got a call on her office phone from Nancy in reception. Nancy notified her that a state trooper had found Dan Carter walking along Highway 2 about ten miles north of Spokane. There wasn’t any information available on his condition, but the trooper was bringing the patient to Medical Lake. Relieved, Alice immediately called Harry. He didn’t answer, probably because he was out looking for Dale, so she left a message on his machine as instructed. Then she went over to the intake building to wait for Dale.

Soon after, the trooper escorted Dale into one of the exam rooms in the intake building. Alice’s heart sank when she saw Dale. The trooper was pulling him by the arm, and Dale followed him obediently, but his eyes once again had that glassy and unfocused appearance they had when he first arrived at Medical Lake.

“Dan?” Alice asked, walking right up to him. He didn’t respond to her voice, and he didn’t seem to see her.

“He hasn’t said a word,” the trooper said. “He’s been like that the whole time. I almost hit him with my patrol car. It’s pitch black at night on that highway once you get out of town, and he was walking right on the edge of the shoulder, almost in the road. I saw him just in time and swerved out of the way, but he didn’t even flinch. So I stopped and pulled over and yelled at him, are you crazy? But he just kept walking. I had to chase after him and pull him into my car. When I saw those scars on his face, I knew right away he was the guy in the APB. Even if he wasn’t, he would have ended up in this place anyway.” The trooper shook his head.

“Thank you for bringing him in, Officer,” Alice said politely.

“No problem. Oh, by the way, his feet look pretty messed up. Bled all over my floor mats, I’m going to have to get them cleaned.”

Alice looked down. There was indeed blood seeping from Dale’s bare feet onto the floor. She hadn’t even noticed initially, because he had been walking normally. He was non-responsive to pain, then. Catatonic, just like she had feared.

The trooper left, and Alice gently sat Dale on the exam table. Now she was alone with him, she said firmly in a low voice, “Dale?” She hoped that he would respond to his real name, if not to his fake one, but to no avail. So she brought out the big guns. “Dale, Harry is on his way. He’s very worried about you. I know you don’t want him to worry. So can you just look at me, please? For Harry.” Still no response.

A nurse came in, and together they did a full physical exam. As the trooper had said, Dale’s feet were indeed pretty messed up. The soles had been worn through and were covered with oozing blisters and blood. Alice also noted that his skin was hot and dry, a sign of dehydration. So she told the nurse to start IV fluids and antibiotics and to debride and bandage his feet. While the nurse got to work, Alice stepped out to the building’s reception area to call Harry again. She updated his answering machine on the situation, breaking the news about the return of the catatonia while trying to sound optimistic that it would be short-lived this time.

As she hung up and headed back inside to help the nurse finish the bandaging, she hoped Harry would arrive soon. She had the strange feeling that Dale was slipping away, like his mind had returned to its prison. She couldn’t keep him from drifting away, but she believed that Harry still could.

It didn’t take long before a commotion from the hallway heralded Harry’s arrival. One of the security guards, clearly having no idea what he was up against, was trying to keep Harry from storming into the exam room. “It’s okay, just let him in,” Alice said, leaning into the hallway.

She saw the moment when Harry saw Dale. It was the moment when Harry looked like someone had just stabbed him in the gut. But he didn’t hesitate. He just walked right up to Dale and took his hand. Alice stayed back in the doorway in an effort to give them some privacy. She could hear Harry speaking to Dale, barely above a whisper, but couldn’t make out what he was saying.

Whatever it was, it did the trick. After just a few seconds, Dale suddenly blinked, then said, “Harry.”

“That was fast,” Alice couldn’t help saying aloud. She had been hoping that Harry would be able to bring Dale back, but she hadn’t expected it to be nearly instantaneous.

Ignoring her, Harry asked Dale, “Are you okay?”

Dale didn’t answer, but suddenly he was crying. That was something he had never done the entire time he had been in the hospital, as far as Alice knew. Harry embraced Dale, and Dale leaned against Harry. Alice discreetly stepped away, not wanting to intrude.

After a few minutes, she returned to the room and asked Dale for more details about what had happened. She was satisfied that, as expected, it had been a transitory relapse in response to a specific trigger. When she brought up the idea of Dale staying overnight for observation, just in case, Dale grabbed Harry’s arm like someone was about to take him away. “I’d rather just go home with Harry,” he said in a small voice. He had clearly been deeply shaken by the trauma he had experienced; he didn’t usually display such open vulnerability. Harry also made it clear by his posture that he wasn’t going anywhere. Wild horses couldn’t have separated them, and Alice didn’t even want to try. She suggested that Harry stay as well, and they both agreed to that.

Before leaving for home, Alice stuck her head in the door of the room Dale and Harry had been assigned to for the night. One of the nurses had brought in a cot for Harry to sleep on, and Harry had apparently pushed it across the room so that it was flush with Dale’s bed. The two of them sat shoulder-to-shoulder, backs against the wall, Dale on the bed and Harry on the cot. They looked like children at a slumber party, and Alice couldn’t help but smile.

“Get some sleep,” she told them.

Harry nodded. “In a while,” he said. Dale lowered his head onto Harry’s shoulder, and Harry put his hand on Dale’s knee. Alice understood. After all those nights they had suffered alone, now they had each other. They wanted to savor that togetherness, which the darkness had once again tried to take from them. As she left, Alice reflected that, powerful as it was, the darkness didn’t stand a chance against those two.

* * *

Just before Christmas, Alice got another call from Harry. This time, he sounded upbeat.

“Harry, it’s been a while,” Alice said warmly. “How are you both doing?”

“We’re okay. Ups and downs, but more ups lately. He got the surgery.”

“Really?” She had been wondering if Dale would ever get his face reconstructed. That had to be a sign of progress. “How did it go?”

“Fine. He’s recovering from it now. They’ve given him all these facial exercises to do, so hopefully soon he’ll be able to smile again. And he’s gotten really into photography lately. He’s amazing at it.”

“That’s great. I’m glad to hear that things are going well.”

“Yeah. So, uh, we were wondering if you would like to meet us for coffee this weekend? We wanted to, you know, thank you. For everything you’ve done.”

“No thanks are needed, but I’d be happy to meet you for coffee. It will be lovely to see you both again.” Normally she didn’t socialize with former patients, but as always, she made an exception for Dale and Harry.

When she walked into the coffee shop, she didn’t see them at first. Then Harry turned around, and she realized that she had been looking right at Dale, who was sitting across from Harry with a cup of coffee. She hadn’t recognized Dale. He looked like an entirely different person. His face had indeed been rebuilt, and now he was quite handsome. He didn’t look quite like the Special Agent Dale Cooper she had seen in photos, but he was a good-looking guy nevertheless. Alice joined them at their table, Harry grinning at her surprised reaction to Dale’s new face.

“He always did get that kind of reaction from the ladies,” Harry said. Alice realized she was blushing.

“Harry, please,” Dale said. “You’re embarrassing her.”

“No, you’re not,” Alice said. “It’s just – well, you look good, Dan.”

Harry went up to the counter to buy Alice a coffee, leaving her alone with Dale. “How are you feeling these days?” she asked him. Even though this wasn’t a therapy session, she couldn’t help but slide back into their old routine.

“Better,” Dale answered. Now she was looking more closely, she could see faint outlines of scar tissue on his face, but they were almost invisible to a casual onlooker. The surgeon had done good work. “I hit rock bottom a few months ago,” Dale continued. “At least, I hope it was rock bottom. But it’s been better since then.”

“Better in what way?” Alice really wanted to ask about the rock bottom part, but this was neither the time nor the place. It was safer to focus on the positive for now.

Dale shrugged. “The photography, mostly. I know it sounds trivial. But I enjoy doing it. I didn’t think I’d ever enjoy anything again.”

“There’s nothing trivial about that.” Alice studied Dale. He still had the same old empty expression that he had worn for the entire time she had known him. She had been accustomed to seeing it on his disfigured face. But now, with his attractive new features, his lack of expressiveness stood out even more. “Harry mentioned that you’ve been doing facial exercises, to try to restore some movement.”

“Yes, that’s right.” Dale’s face was a stony mask. He would make a killing at poker.

“How is that going?”

Dale finished off his cup of coffee. “I’m trying. It’s important to Harry. And that makes it important to me.” He stared her down, as if daring her to say that he needed to think of his own needs first. But she wasn’t going to say that. She could see that Dale’s and Harry’s needs were all tangled up together, for better or worse. Mostly for better, she thought.

Harry returned with a cup of coffee for Alice. He also brought a refill for Dale, smoothly sliding the just-emptied cup out of the way and replacing it with the new one. Apparently, Harry was attuned enough to Dale’s coffee intake rates that he was able to anticipate the exact moment that a refill would be needed.

The three of them spent a pleasant hour chatting about Harry’s job, the photography expeditions he and Dale had been going on, and the latest exhibit at the art museum. All the while, Alice observed Dale and Harry. Despite his continued lack of facial expression, Dale really did seem to be doing better. Harry was doing most of the talking, but Dale contributed occasional anecdotes, and his voice was more animated than Alice had ever heard it. Even while he was silent, he seemed content. At Dale’s prompting, Harry told a story about a fight he had to break up between two elf-costumed mall employees in front of a crowd of children waiting to see Santa. As Alice laughed at the story, she saw that Dale was watching Harry with an expression that had softened somehow. Nothing had actually changed in his face, but his eyes seemed warmer, like there was a smile inside him that was trying to break out. Something else Alice hadn’t gotten used to with Dale’s new face was how young he looked. She had known that he was young, of course, but with his scars and general air of world-weariness, he had seemed much older than he was. Now, she supposed she was getting a glimpse of him as a young man again. She hoped that he felt that way too, that he was getting a second chance at life. If he didn’t feel that way now, maybe he would someday.

As Alice stood up to leave, Harry reached under the table and pulled out a large flat sheet wrapped in brown paper. Handing it to her, he said, “Just a little thank-you gift.”

Alice unwrapped it to find a photo print of a vineyard, the vine leaves tinted golden yellow. It was professional-quality, like something from a coffee-table book. “It’s beautiful. You took this, Dan?”

Dale nodded. “It was down in the Walla Walla valley a couple of months ago.”

“That was a good day,” Harry said, smiling.

‘Yes, it was.” As he spoke, Dale sounded happier than Alice could remember him ever sounding before. Beautiful though the photo was, she would treasure it even more knowing that the process of taking it had brought that elusive quality of joy into Dale’s life.

Before leaving, Alice told Dale, “I see a lot of positive changes. You’ve made so much progress in less than a year.” It was true. Downhearted though he still seemed, he wasn’t even recognizable as the bloodied and speechless man who had been brought to the hospital ten months before. Impulsively, she hugged Dale, then Harry, and said her goodbyes. She hoped that it really was goodbye in that they would have no further need of her services. If she never saw them again, that would mean that she had done her job right.


	10. Chapter 10

_18 Months Later_

Summer had arrived with grace, and the whole world was blooming. Even the parking lot of the Eastern State Hospital was a scene of idyllic beauty, studded with lilac blossoms. Exiting the hospital to head home after her shift, Alice stopped to pluck a lilac bunch from the tree her car was parked under. She would put it in water when she got home and then bring it with her to the reservation in the morning. Gran had loved lilacs, so Alice would bring her some. Tomorrow was the one-year anniversary of Gran’s death, so Alice and all her siblings and cousins were planning to meet at her grave, under the ponderosa pine in front of her house.

Alice got her in car and started driving home, feeling melancholy. She had been the last one to see Gran before the massive stroke that had taken her life. Alice had once again been trying to persuade Gran to move into town to be closer to medical care, and Gran had once again refused, saying she wanted to die on her own land so she could join her ancestors. Frustrated, Alice had said that there was no need for her to join her ancestors yet, not when there were medical treatments available that could extend her life. Gran had smiled and shaken her head. “Little one, I know you have your medicines,” she had said. “You’ve been seeking them ever since you watched your daddy’s soul get taken by sickness. But you know there’s different kinds of medicine. There’s more to us than just chemicals and electricity. You have to see the spirit too. Then you’ll be not just a doctor, but a healer.” That had been the last thing Gran had said to Alice.

Alice rolled down the window, wanting to breathe in the flower-scented breeze to ease her grief. Tomorrow would be the time for mourning. For now, she was going home to someone she loved. She had met Mark just a few weeks after Gran’s death, and he had been there for her. She had been so lucky to find someone right when she needed it most.

When she got home, Mark was already there. He greeted her with a kiss. Alice filled a vase with water for the lilacs, then changed her clothes for the evening. Her first date with Mark had been to the First Friday art-gallery openings in downtown Spokane, and they had kept going to the galleries together every month as a tradition. It was like experiencing their first date all over again every month, minus the initial awkwardness. There was always something new to look at in the galleries, and Alice loved discovering new things with Mark.

It was a perfect evening, with a slight breeze to keep things cool as the downtown buildings and sidewalks gave up the day’s heat. Alice and Mark made the usual round of their favorite galleries, sipping on wine and munching on cheese as they explored collages and found-object sculptures and mixed-media social commentaries. They wandered into one gallery that had a banner over the door, proclaiming “The best new local artists!”

In the new artist exhibit, Alice’s eye was immediately drawn to a wall of what she first took to be abstract paintings. Moving closer to examine them, she saw that they were actually photographs. Their subjects were initially difficult to recognize, because most of them were tiny objects that had been taken with a macro lens. There was a water strider on a still water surface, with a perfectly mirrored reflection beneath. There was a close-up of a dragonfly’s iridescent wings, which had the effect of the inside of a kaleidoscope. Alice paused in front of one especially striking photo of a spiderweb covered in dew. The dewdrops were reflecting the ambient lights in all its colors, and the whole scene looked something like a mandala from a Buddhist temple. A thought suddenly struck Alice, and she looked at the small placard next to the photo. Sure enough, the artist’s name was listed as Dan Carter.

“These are fascinating,” Mark said from beside her.

“I know the photographer,” Alice told him. Instinctively, she looked around the crowded gallery. Across the room, she caught sight of Dale, who was talking to an elderly couple and gesturing at one of his photos. “That’s him,” she said to Mark, pointing him out.

“Well, let’s go say hello,” Mark said, starting in that direction. Alice hesitated. Maybe Dale would feel a bit awkward about his former psychiatrist crashing his gallery opening. But before she could say anything to Mark, Dale finished his conversation with the couple. He glanced across the room and made eye contact with Alice. Breaking out in a grin, he started making his way toward her.

“Dr. Sherman,” he said as he arrived. “So great to see you.” Alice had never seen him smile before, and it was truly a dazzling sight to behold. Apparently, the facial exercises had worked.

“Do you work with Alice at the hospital?” Mark asked, obviously assuming that it must be through the hospital that they knew each other since Dale had addressed her as Doctor.

“No,” Dan said, still smiling. “I’m a former patient of hers. She was a great help to me.” He stuck out his hand for Mark to shake. “I’m Dan Carter.”

Mark introduced himself, slightly thrown off. He was an accountant, and Alice’s world of psychiatry was mysterious to him. He had never met one of her former patients before, and he seemed a bit surprised that such a charming and successful man was a formerly institutionalized mental patient. But to his credit, Mark shook off his surprise quickly and started asking intelligent questions about the composition of the photos and the equipment Dale had used. Alice smiled as the two of them chatted. Mark was a lot more knowledgeable about art than she was, and Dale seemed delighted to have someone to talk with about the technical details.

“Where’s Harry?” she asked when she could a word in edgewise. It didn’t even occur to her that Harry could possibly be somewhere other than nearby.

Sure enough, Dale said, “He’s getting me coffee.” Of course.

“And how are you both doing?” She tried to ask it as casually as possible, so she wouldn’t sound like she was subjecting him to therapy.

“We’re doing well. We have a boat now. We go fishing in Lake Coeur d’Alene most weekends. Harry swears he had a forty-pound pike on the line a few weeks ago, but we’ll never know for sure because it got away.”

“It was fifty pounds, minimum,” Harry said, coming up behind Dale and handing him a coffee.

“I trust your authority on these matters,” Dale said, smiling at Harry indulgently and sipping his coffee.

“Nice to see you, Doc,” Harry said. “I’m Harry,” he said to Mark, who shook his hand and introduced himself.

“It looks like your photography is generating quite a bit of interest,” Alice said to Dale, gesturing at the crowded gallery.

“He’s already sold two pieces just tonight,” Harry said, grinning proudly. “And he has a show in Seattle next month.”

“It’s not as impressive as Harry makes it sound,” Dale added. “Just a shared exhibit at a small gallery.”

“It’s wonderful,” Alice said. “Are you doing this full-time now?”

“I only make a pittance from selling pieces. Mostly, I supplement our income by doing photography at events.”

“Do you do weddings?” Mark asked with interest.

Dale looked back and forth between Mark and Alice and raised his eyebrows. “Am I to understand that congratulations are in order?”

Alice smiled and held up her hand to show off the engagement ring. Mark put his arm around her shoulders.

“Congratulations to you both,” Dale said, beaming.

Harry added, “You’re a lucky man, Mark.”

“Don’t I know it,” Mark said, lacing his fingers between Alice’s.

“If you need a photographer for your wedding, it would be my honor,” Dale said. “No charge, of course.”

Alice and Mark looked at each other. “We would love to have you as our photographer,” Alice said.

“But we’ll pay your usual rate,” Mark finished.

“No, after everything, this is the least I can do –” Dale argued.

Harry broke in, “We can work out the details later. How about you take a card and give us a call?” He handed Alice a professional-looking business card.

Alice and Mark agreed, then said their goodbyes and went back out into the summer night. “Should I not have said anything?” Mark asked suddenly. “I didn’t even think that it might be weird for you to have a former patient at our wedding.”

“No, it’s not weird,” Alice said reassuringly. “I’m glad you offered.”

“Okay, good,” Mark said, looking relieved. “I mean, Dan is a great photographer, and they seem like nice guys.”

“Yeah, they are.”

“Dan was – a patient?”

Alice nodded. “I can’t talk about it, of course.”

“I know. It’s just hard to believe. He seems so – healthy. You must be a damn good psychiatrist.” Mark grinned at her.

“I am.” Alice grinned back. “But honestly, I don’t know how much credit I can take in this case. It was mostly Harry.”

“Are they, uh, together?”

“Yeah. I mean, I don’t know the details. But yes, they’re together.” Alice wasn’t sure if they were still pretending to be cousins, but that was beside the point. It was obvious to anyone who spent five minutes with them that they were together, in every way that mattered.

* * *

A couple of weeks later, Alice headed to the Manito Park botanical gardens to meet Dale and Harry after work. The plan was to scout out the gardens – the wedding venue – so that Dale could identify the best photo locations in advance. Mark had said he had to stay late at the office, so she was handling the meeting on her own. She suspected that he really just wanted to give her a chance to check in with her former patient while maintaining confidentiality. She appreciated that he understood her so well.

Dale had requested that they meet at a very specific time, and it turned out that he had a reason for it. Right now was almost the summer solstice, when the days were longest, but the wedding was two months away. So Dale had looked up sun charts so he could figure out what time of day now corresponded with the sun angle as it would be on the date and time of the wedding, and had suggested that as the time for their meeting so that he could get a sense of what the light would be like on the big day.

“I never would have thought to consider the sun angle,” she said as Dale set up a reflector to maximize the diffuse lighting.

“That’s what photography is all about,” Dale said. “The art of light.”

Dale took a series of test shots at the location where the main ceremony would take place, then the three of them spent an hour walking around the garden to identify optimal spots for portraits. Finally, Dale was satisfied that he had found a few locations that were optimally lit and had scenic backgrounds. They also finally settled the payment issue. The compromise was that Alice and Mark would pay Dale for his services, but only half his usual rate. Alice was satisfied that they were at least giving Dale something, but she was also grateful for the discount. After all, she and Mark had gone over budget on the venue and catering, so saving some money on the photographer was helpful.

Their business settled, Dale smiled his blindingly bright smile at Alice. “You’re going to have a beautiful wedding,” he said.

“Well, I’m glad you’ll be there to document every moment of it,” Alice replied.

“Don’t joke about that,” Harry said. “He takes his wedding photography duties very seriously. You used, what, four rolls of film at that last one?”

“Three and a half, but only because the bride insisted on getting shots of her with every possible combination of all twelve of her bridesmaids.”

“Yeah, that was a long day. Anyway, Doc, do you have time for a cup of coffee before you go?”

“Sure, I’d love to.” Alice usually didn’t drink coffee this late in the day, but she wanted to spend some time catching up with Dale and Harry, and spending any amount of time with them inevitably involved coffee.

The park had a nice little outdoor café, so they sat at a table underneath a wisteria arbor. Harry went to get coffee for them all. Alice was glad to have a moment alone with Dale. He seemed so happy, so unlike the withdrawn patient who had been in her care. It was like she was meeting him for the first time. She was finally seeing the person Harry had described to her, the one who was interested in everything and took delight in things most people never gave a second thought to. But the transformation was so dramatic, she couldn’t be sure if his outward demeanor reflected how he truly felt.

“I know I’m not your doctor anymore,” Alice said. “But if you’d like to tell me more about how you’re doing, I’m always happy to listen.”

“I really am doing well,” he said quietly. “Not all the time, of course. There are still days when I feel like part of me is still back there.” Alice wasn’t sure if _back there_ was the Black Lodge, or Eastern State Hospital, or maybe even somewhere that wasn’t a place but the state of mind he had been in. “But I know who I am now,” Dale continued. His eyes turned automatically to Harry, who was approaching the table with three coffee cups expertly balanced in his hands. Dale took a sip from his cup and said, “That is some damn fine coffee.” He and Harry grinned at each other.

Alice didn’t know what made her speak. Maybe it was Dale saying _I know who I am now_. Maybe it was Gran’s voice in her head, saying _You have to see the spirit too_. Whatever it was, she suddenly felt compelled to speak to Dale rather than Dan, to tell him that she saw him, that she knew who he was. Hardly even aware of what she was doing, she leaned forward across the table and said in a hushed voice, “It’s good to finally meet you, Dale.”

Dale and Harry both froze. “You know,” Dale said, sounding shocked.

All the blood had drained from Harry’s face. “No, you don’t know anything,” he said to Alice desperately. “Whatever you think you know, you’re wrong.” He had grabbed Dale’s arm like he was preparing to run off with him. Alice had a vision of having to explain to Mark that they needed to find a new wedding photographer, one they would have to pay full price for, because she had with a single word spooked Dale and Harry into fleeing across the Canadian border. Maybe it hadn’t been a good idea for her to say anything after all.

But Dale was studying her face, and he seemed to come to a realization. “Harry, it’s all right. She understands.”

“I do,” Alice said, grateful for the opportunity to explain herself. No one was around them, but she kept her voice low anyway. “I know about the Black Lodge, and your shadow self. I know it wasn’t you who did those terrible things. I know you’re a good man, Dale.”

Harry and Dale glanced at each other, then Harry leaned back in his chair, apparently resigned to the fact that she knew their secret. “Well, I’ll be damned,” Harry said, grudgingly impressed. “How did you figure it out?”

“Lots of little things. Don’t worry, I don’t think anyone else would be able to put it together, not unless they spent as much time talking to you both as I did. And not unless they heard my grandmother’s stories.”

“So you won’t tell anyone.” Harry said it like he already knew the answer but had to make absolutely sure.

“Of course not. Patient confidentiality.”

“I’m glad you know what really happened,” Dale said. “The whole experience was difficult for both of us.”

“That’s an understatement,” Harry said dryly.

“There are very few people we can talk to about it,” Dan continued. “So I’m glad we can talk to you. You always were a good listener.”

“That’s my job,” Alice said. “And you can both talk to me, anytime.” She paused. “It’s the stuff of legend, you know. No one ever comes out. And if they do, they don’t come all the way back. It took great strength to find your way out of the darkness.”

“Harry found me,” Dale said simply.

“Always will,” Harry said. He still hadn’t let go of Dale’s arm.

After a moment of silence, Dale changed the subject, asking Alice a few more questions about the wedding ceremony. He scribbled down some notes about the size of the wedding party and the number of portraits he would likely need to take. Alice gratefully shared all the details she could think of, relieved that she hadn’t scared them off after all.

When they had finished their coffee, they all walked together back through the garden toward the entrance. The prolonged solstice sunset was just beginning. Alice remembered another garden, the one she had looked at from her office window to watch the Dale and Harry strolling around. Even back then, she had gotten the sense that Harry was leading Dale back into the world of light and growth and life. She hadn’t realized then how literally true that was.

When they got to the parking lot, Alice said good night. She lingered for a moment to stand in the garden, breathing in the lilac-scented air that reminded her of Gran. As Dale and Harry headed toward their truck, the evening light draped itself over them. It looked like they themselves were radiating the light, like the photo reflector Dale had set up. It was a golden glow, shared between them, something they had created together. Alice could hear Gran’s voice in her head, telling her _There’s different kinds of medicine_. To her people, of course, medicine was more than just drugs. It was sacred lakes and lonely mountain peaks and vision quests and drum circles and bison hunts and salmon runs. And the light she could see between Dale and Harry, that was medicine too.


End file.
